Severe bilateral hydrocarbon pneumonitis requiring surgical drainage following accidental aspiration of industrial cleaning solvent in a seafarer: a case report.

BACKGROUND: Hydrocarbon pneumonitis is typically self-limiting, and severe complications, such as lung abscesses, are rare. Here, we report the case of a seafarer who developed bilateral lung abscesses after aspirating an industrial cleaning solvent, highlighting the aggravating role of delayed medical care and improper first-aid measures in a maritime setting.

CASE PRESENTATION: A 46-year-old seafarer presented with dyspnea, 3 days after accidentally ingesting a hydrocarbon-based solvent that he mistook for water. Although he immediately spat out the fluid, he aspirated a small amount. His condition rapidly deteriorated to necrotizing pneumonia with bilateral lung abscesses, as confirmed by chest computed tomography. Despite empirical antibiotic therapy, the abscess worsened, necessitating a video-assisted thoracic surgery for drainage. The patient recovered after surgery and underwent a prolonged course of antibiotic therapy.

CONCLUSIONS: This case underscores the potential for life-threatening complications from industrial solvent aspiration, exacerbated by delayed medical care and forceful spitting. Strict workplace safety protocols, including the prohibition of storing chemicals in food containers to avoid confusion, and awareness about not inducing vomiting after ingestion, are essential to prevent such severe occupational injuries.