High-voltage electrical injury complicated by diffuse pulmonary haemorrhage: a case report.

BACKGROUND

High-voltage electrical injury is rare but potentially fatal, often affecting multiple organs. Pulmonary haemorrhage is an exceptionally uncommon complication.

CASE PRESENTATION: A 56-year-old man sustained a 100-kV electrical injury with 40% total body surface area burns. On hospital day 4, he developed acute dyspnoea and haemoptysis. Chest CT revealed rapidly progressive bilateral infiltrates, and fiberoptic bronchoscopy confirmed diffuse endobronchial haemorrhage. He received invasive mechanical ventilation, repeated bronchoscopic clearance of bloody secretions, continuous renal replacement therapy, and comprehensive intensive care. Pulmonary haemorrhage gradually resolved, and he was successfully extubated. However, on day 19, he developed massive gastrointestinal bleeding resulting in haemorrhagic shock and death despite aggressive resuscitation.

CONCLUSIONS

High-voltage electrical injury may directly involve the lungs and cause diffuse pulmonary haemorrhage. Early recognition and prompt intervention are essential to improve outcomes.