Accidental poisoning by intramuscular injection of dichloromethane and trichloroethylene: A case report

Abstract

Introduction: Dichloromethane (DCM) and trichloroethylene (TCE) are both common halohydrocarbons which are widely used in industry. The most common exposure route of DCM or TCE is inhalation, but intramuscular injection of DCM and TCE is very rarely. Case presentation: A 47-year-old male presented ecchymosis, pain, and swelling of the left limb following accident injection of ABS glue (main ingredients were DCM and TCE). The swelling of his left limb was lasted until day 6 and WBC, NEUT, CK, CK-MB, LDH, AST and ALT were elevated until day 9. He was received intravenous fluids, analgesic, antibiotics, and other supportive measures and finally discharged from the hospital on day 16. Discussion: Both DCM and TCE could cause local irritation and systemic toxicity involving central nervous system, liver, kidney and other organs. In this case, because the small dose of toxicant and injection being the route of exposure, the patient mainly suffered from local toxicity resulting in painful soft tissue swelling with slight hemocytology and biochemistry disorder. Although there are no specific antidotes for DCM and TCE poisoning, supportive measures may also provide satisfactory therapeutic results. Conclusions: DCM and TCE poisoning following intramuscular injection could present mainly with local and system poisoning symptoms and successfully treated with supportive measures.