Ingestion and aspiration of hot candle wax.

We present a toddler pre-alerted to our emergency department following hot candle wax ingestion and potential aspiration. He was stable but had a new continuous cough, hoarse voice, erythema and blistering around the oral cavity. Given the limited guidance on Toxbase and literature on candle wax ingestion and the risk of hydrocarbon pneumonitis from paraffin, a multidisciplinary team discussion occurred, and the child was electively intubated with a plan for bronchoscopy and endoscopy. Endoscopy revealed superficial ulceration at the distal oesophagus with clumps of wax in the stomach adherent to the mucosa. Bronchoscopy revealed thick casts of wax, especially in the left lower lobe, which were removed. Repeat endoscopy revealed normal mucosa with a mobile mass of wax in the stomach, and the child was discharged on day 5. In the future, we would advocate early endoscopic and bronchoscopic assessment to guide management of this rare injury.