Define Kerosene (Hydrocarbon) Poisoning. Describe its clinical features, management, complications and prognosis.

Definition

• Kerosene (hydrocarbon) poisoning is a common accidental childhood poisoning.
• Because kerosene has low viscosity and high volatility, its main danger is aspiration causing chemical pneumonitis, not systemic absorption.

Clinical Features

• Respiratory (from aspiration) — coughing, choking, tachypnoea, respiratory distress and fever (chemical pneumonitis).
• CNS depression (drowsiness) and gastrointestinal irritation may occur.

Management

• Do not induce vomiting or perform gastric lavage — this greatly increases the risk of aspiration.
• Supportive care — oxygen, respiratory support, and management of pneumonitis.
• Routine prophylactic antibiotics and corticosteroids are not recommended; antibiotics only if secondary infection develops.
• Observe for delayed respiratory deterioration.

WHY Gastric Measures Are Harmful

Hydrocarbons are poorly absorbed from the gut but readily aspirated; inducing vomiting or lavage risks pushing kerosene into the lungs, worsening chemical pneumonitis — hence supportive care is preferred.

Complications

• Chemical pneumonitis with hypoxia; rarely secondary bacterial pneumonia, pneumatocele, or effusion.
• CNS depression and, uncommonly, systemic effects.

Prognosis

Most children recover with supportive care; the course is determined by the severity of the chemical pneumonitis.

Prevention

Many paediatric emergencies are preventable — safe storage of poisons/medicines, supervision, protective measures and prompt first aid substantially reduce serious harm and mortality.

Never induce emesis or lavage — aspiration is the danger.