Chronic reactive airway disease following Chlorine inhalation lung injury

M. Nepal, Rebecca Heintzelman
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Abstract

Inhalations of smoke and toxic fumes from chemicals like chlorine are known to cause mild mucosal irritation with lacrimation, nasal congestion, nasopharyngeal edema, transient reversible reactive airways and sometimes acute respiratory failure in the setting of acute respiratory distress syndrome due to bronchospasm, pulmonary consolidation presenting with rapid onset symptoms of cough, wheeze and shortness of breath. Inhalations of these fumes have also been known to cause on rare occasions diffuse bronchiolitis and chronic respiratory sequelae including decreased lung function and persistence of asthma. We are reporting one such rare case report of acute inhalation lung injury that developed progressive shortness of breath and bilateral lung consolidation as a result of inhalation of chlorine fumes from bleaching agents and later recovered on high dose steroids slowly over months only to have chronic reactive airway dysfunction syndrome requiring bronchodilator therapy.
氯吸入性肺损伤后的慢性反应性气道疾病
众所周知,吸入氯等化学物质产生的烟雾和有毒烟雾会引起轻度黏膜刺激,包括流泪、鼻塞、鼻咽水肿、短暂的可逆反应性气道,有时还会引起急性呼吸衰竭,这是由于支气管痉挛、肺实变引起的急性呼吸窘迫综合征,并伴有咳嗽、喘息和呼吸短促等快速发作的症状。在罕见的情况下,吸入这些烟雾也会引起弥漫性细支气管炎和慢性呼吸道后遗症,包括肺功能下降和哮喘持续存在。我们报告一例罕见的急性吸入性肺损伤病例,由于吸入漂白剂产生的氯烟雾而出现进行性呼吸短促和双侧肺实变,随后在数月的高剂量类固醇治疗下缓慢恢复,最终出现慢性反应性气道功能障碍综合征,需要支气管扩张剂治疗。
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