Presentation of Kerosene Pneumonia and the Role of Corticosteroids in Its Management

Abstract

Objective: Accidental kerosene pneumonia is common form of acute childhood poisoning. Corticosteroid is used for treatment of kerosene pneumonia. This study has been conducted to clarify the presentation of kerosene pneumonia and the role of corticosteroid in its management.
Methods: One hundred twenty two children with kerosene poisoning admitted to kerbala teaching hospital for children from January 2006 to January 2008. (Two patients were excluded from the study because they died within few hours after arrival, one due to deep coma and the other due to severe abdominal distention and bleeding per rectum). Sixty patients were chosen for corticosteroid therapy and 60 patients were taken as a control group. Symptoms and signs were recorded; chest x-ray, leukocyte counts and erythrocyte sedimentation rate also obtained at first, third, fifth, eighth and twelfth days of admission
Results: Of the 120 admitted children, 71(59.2%) were boys and 49(40.8%) were girls, with ages ranging from 6 months to 6 years .The largest group, (48.4%,) were admitted during the summer months .The most commonly observed symptoms were tachypnea (66.6%), fever (58.3%), cough (54.1%) ,vomiting (45.9%), 18% of the patients showed signs of central nervous system (CNS) impairment, including drowsiness, restlessness, and stupor.
There was no difference between the two groups who were treated with corticosteroid and those without corticosteroid regarding the clinical course, duration of illness, fever, respiratory rate, heart rate, leukocyte counts, Erythrocyte Sedimentation Rate, and changes in x-ray findings
Conclusions: There is a higher risk of hydrocarbon poisoning during the hot months of the year; the respiratory system is the main target organ affected, vomiting after hydrocarbon ingestion is related to the rate of development of pneumonia; symptoms of central nervous system impairment were correlated with pneumonia, and fever. Corticosteroids are ineffective in altering the acute course of hydrocarbon pneumonia, shortening the duration of the disease, alleviation of symptoms and signs or prevention of complications.