Manfra Andrew, Sharma Jill, Kilburn Jeremy
Internal Medicine, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, Las Vegas, USA.
Pulmonary and Critical Care Medicine, University of Nevada, Las Vegas School of Medicine, Las Vegas, USA.
Cureus. 2023 Apr 25;15(4):e38116. doi: 10.7759/cureus.38116. eCollection 2023 Apr.
Hydrogen peroxide is a chemical commonly used as a household antiseptic for cleaning and disinfecting. No cases of acute hydrogen peroxide inhalation-induced lung injury are previously described. We present a case of acute chemical pneumonitis caused by mixing hydrogen peroxide in a nighttime continuous positive airway pressure device's humidifier used for obstructive sleep apnea to prevent COVID-19 infection. The patient endorsed mixing hydrogen peroxide with distilled water in his nighttime continuous positive airway pressure device's humidifier at a ratio of 1:3-1:2 for the previous week before admission based on a friend's advice in preventing COVID-19. The presenting chest X-ray showed new multifocal consolidations with interstitial markings and alveolar edema throughout both lungs. Chest computed tomography (CT) imaging demonstrated multifocal, bilateral, hazy consolidations with increased interstitial markings and bilateral pleural effusions. The patient was subsequently initiated on systemic glucocorticoid therapy, significantly improving hypoxemia and dyspnea. Inhalation of hydrogen peroxide may produce acute pneumonitis distinct from what has been described previously with chronic inhalation. Given this case, systemic glucocorticoid therapy may be considered a viable treatment option for acute hydrogen peroxide-associated inhalation lung injury causing pneumonitis.
过氧化氢是一种常用作家庭消毒剂的化学品，用于清洁和消毒。此前尚未有过氧化氢吸入导致急性肺损伤的病例报道。我们报告一例急性化学性肺炎病例，该病例是由于在用于阻塞性睡眠呼吸暂停的夜间持续气道正压通气设备的加湿器中混合过氧化氢以预防新冠病毒感染所致。患者承认，在入院前一周，根据朋友预防新冠病毒的建议，他以1:3至1:2的比例在夜间持续气道正压通气设备的加湿器中混合过氧化氢和蒸馏水。胸部X光显示双肺出现新的多灶性实变，并伴有间质纹理和肺泡水肿。胸部计算机断层扫描（CT）成像显示多灶性、双侧模糊实变，间质纹理增多，双侧胸腔积液。患者随后开始接受全身糖皮质激素治疗，低氧血症和呼吸困难明显改善。吸入过氧化氢可能会导致与之前慢性吸入所描述的情况不同的急性肺炎。鉴于此病例，全身糖皮质激素治疗可能被认为是治疗过氧化氢相关急性吸入性肺损伤所致肺炎的可行选择。
