Ammonia Inhalation Toxicity: A Case Report

Abstract

Inhalational ammonia exposure may occasionally occur in industrial set up. Anhydrous ammonia is a colorless, pungent gas that may be stored or transported in pressurized liquid form. Here we present a case report on accidental ammonia inhalation, its clinical findings and management. A 55 year old male was exposed to inhalation of leaked ammonia gas from the pipeline of a fertilizer factory and came to the hospital after referral within 6 hour after exposure. The patient was presented with mild dyspnea, giddiness, gastrointestinal irritation, conjunctivitis and mucosal burning. The patient was managed aggressively with decontamination, fluid irrigation, IV fluid, steroid, bronchodilators, antibiotics, tear supplement and antibiotics eye drop. The patient was monitored for partial pressure of oxygen, oxygen saturation, pH, ECG, electrolytes, liver enzymes, renal function, CBC and chest X-ray. The patient was discharged in normal condition with follow up advice after 5th day of admission. Immediate decontamination with maintenance of airway, breathing and circulation is crucial followed by monitoring is key for the management. Immediate conservative management of these patients led to good prognosis; otherwise it is usually fatal within first 4-6 hour of exposure.