A Newborn Case of Esophagus and Vocal Cord Burn After CS (O-Chlorobenzylindene Malononitrile) Gas Inhalation.

Abstract

Among the agents used for self-defense, O-chlorobenzylidene malononitrile (CS) is the most commonly used substance. It has been suggested that CS use is characterized by rapid onset of action, short duration of action, and minimal side effects. When the clinical situations and case series resulting from exposure to CS were examined, we saw that no cases of exposure during the neonatal period were identified. A male baby born at 40 weeks, weighing 3260 grams, was brought to the emergency room on the 24^th postnatal day with bruising and respiratory distress due to a stranger spraying CS into his mouth. There was a widespread hyperemic erosive lesion in the mouth, tongue exfoliation, and leg ecchymosis. Widespread edema and hyperemia were observed in the vocal cords, and the patient was intubated and followed up. An epithelial defect involving the corneal limbus and conjunctiva was detected in the upper and lower eyelid membranes. Endoscopy revealed a grade 2 burn in the esophagus, and normal pseudomembrane and gastric mucosa in some areas. It was observed that the lesions around the patient's mouth and tongue completely resolved. After discharge, the esophagus-stomach-duodenum radiograph showed no suspicion of obstruction. At the 3rd-month post-discharge check-up, his eye examination was normal, and his stridor and wheezing at rest continued. This case, in which we have shown that CS used for self-defense or riot suppression, seriously threatens the life of a newborn patient for the first time and may perhaps cause permanent morbidities during follow-up, suggests the need to restrict access to such substances.