American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2017, 5(9), 234-236
DOI: 10.12691/ajmcr-5-9-1
Open AccessCase Report

An Ingestion of Industrial Strength Hydrogen Peroxide Resulting in Cerebral Embolism and Death

Muhammad Sohaib Afzal1, , Saleha Sharif Dar1, Tayyaba Sarwar1 and Muhammad Zubair Afzal2

1Quaid-e-Azam Medical College, Bahawalpur, Pakistan

2Dartmouth-Hitchcock Medical Center, Lebanon, NH USA

Pub. Date: September 08, 2017

Cite this paper:
Muhammad Sohaib Afzal, Saleha Sharif Dar, Tayyaba Sarwar and Muhammad Zubair Afzal. An Ingestion of Industrial Strength Hydrogen Peroxide Resulting in Cerebral Embolism and Death. American Journal of Medical Case Reports. 2017; 5(9):234-236. doi: 10.12691/ajmcr-5-9-1

Abstract

Hydrogen peroxide is a well-known remedy used in homeopathic medicine. Accidental ingestion can have a broad range of side effects depending upon the quantity and concentration of ingestion. Air emboli to the brain have been reported in very few case reports. We present an interesting case of accidental ingestion of 35% hydrogen peroxide resulted in ischemic stroke and seizures due to air embolism. Our patient was an elderly woman who accidentally drank industrial strength hydrogen peroxide thinking of water. Upon ingestion of approximately two tablespoons of hydrogen peroxide, she developed respiratory distress within few minutes. She was reported to have a frothy mouth and soon became unresponsive. EMS arrived and intubated her on her way to the hospital. A CT of the chest/abdomen/pelvis showed air in the heart, spleen, splenic and portal veins. A CT, MRI of head and EEG were performed to evaluate her altered mental status. She was treated with phenytoin, midazolam for seizure prophylaxis and hyperbaric oxygen for the air embolism without improvement. The family ultimately decided to transition to comfort measures only. This is a rare case of air embolism. About 20% of air-embolism occurs in contrast enhanced CT’s. Very rarely it can be because of hydrogen peroxide poisoning. Hydrogen peroxide has many common uses but has a great potential for misuse. Hyperbaric oxygen has a role in both limiting damage and enhancing recovery. This is the current standard of care as documented in previously reported case.

Keywords:
hydrogen peroxide cerebral embolism air embolism ischemic stroke

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