Carbon tetrachloride poisoning from an antique fire extinguisher

• Published in: The American journal of emergency medicine 2020-10, Vol.38 (10), p.2139-2141
• Main Authors: Meaden, Christopher W., Procopio, Gabrielle, Calello, Diane P., Nelson, Lewis S., Ruck, Bruce, Gupta, Amit, Jacob, Jeena E.
• Format: Article
• Language: English
• Subjects: Abdomen; Acetylcysteine; Adult; Air temperature; Analgesics; Antique; Blood pressure; Carbon; Carbon tetrachloride; Carbon Tetrachloride - adverse effects; Carbon Tetrachloride - toxicity; Carbon Tetrachloride Poisoning - complications; Carbon Tetrachloride Poisoning - etiology; Diabetes mellitus (insulin dependent); Diarrhea; Differential diagnosis; Emergency medical care; Emergency medical services; Emergency Service, Hospital - organization & administration; Fire extinguisher; Fire extinguishers; Fire Extinguishing Systems; Free radicals; Heart rate; Hematemesis - etiology; Hepatitis; Hepatology; Hepatotoxicity; Humans; Hyperlipidemia; Hypertension; Hypothyroidism; Insulin; Kidneys; Laboratories; Lipid peroxidation; Liver - abnormalities; Liver - drug effects; Liver - physiopathology; Male; Metabolism; Metabolites; N-acetylcysteine; Nausea; Oxygen saturation; Pain; Patients; Respiration; Toxicity; Ultrasonic imaging; Vomiting; Vomiting - drug therapy; Vomiting - etiology
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2020.07.052

Both cases recovered after treatment with N-acetylcysteine (NAC).2 Case 1 A 31-year-old male with a past medical history of insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and hypothyroidism presented to the emergency department with vomiting, diarrhea, and fatigue for one day. When he arrived at the new facility, the patient had a heart rate: 67 beats per minute, blood pressure: 127/92 mmHg, respiratory rate: 20 breaths per minute, oxygen saturation: 96% on room air, and a temperature: 980 F. He was well appearing, non-icteric, and his abdomen was soft, non-tender, and non-distended. (Table 1).3 Case 2 A 24-year-old male, the brother of case 1, with no significant past medical history presented to the emergency department 12 h after his brother's initial presentation with complaints of abdominal pain, vomiting, and hematemesis. The cases described presented with non-specific symptoms and a transaminitis that was initially unexplained. Since CCl4 is rarely used, it is less likely to be on the differential diagnosis of most clinicians.