الفهرس 
Childhood PoisoningOnly 14 pages are availabe for public view
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Abstract
Acute poisoning is now a common pediatric emergency and is one of the important causes of morbidity and mortality in children specially in developing countries.
Accidental kerosene poisoning is one of the most common forms of acute childhood poisoning in most developing countries, where kerosene is used as fuel for cooking, heating and cleaning purposes.
The primary threat to life after the ingestion of kerosene is respiratory failure, which results from chemical pneumonitis resulting from aspiration of vomitus following ingestion. Kerosene pneumonitis is usually self-limited and secondary infection is rare with most patients recove on supportive therapy.
This study was carried out on all children under 7 year, of kerosene poisoning admitted for treatment to the Poisoning Control Center, Ain Shams University Hospitals, from January 2004 to December 2005 for a retrospective study and through 2006 for a prospective study.
The aim of this work is to investigate the demographic pattern, clinical manifestations, severity, treatment and outcome of children with acute kerosene poisoning.
The present study showed that, the majority of the cases were in the age group below 5 years (99.4%), and as regard sex distribution, males (63.9%) outnumbered females (36.1%), with males to females ratio of 1.8: 1.
Most of the patients come from urban araes (92.5%) and only (7.5%) patients were from rural areas. There is a higher risk of kerosene poisoning during the hot months, as most cases were admitted during the summer season (54.6%) in comparison with autumn, spring and winter.
All patients exposed to kerosene orally and (57.01%) of patients exposed to it both orally and dermaly.
Accidental poisoning was noted in all cases (100.0%). There were no suicidal or homicidal cases.
Vomiting was induced at home in 212 (63.3%) children either by mothers or caretakers before transporting them to the hospital. There was a highly significant relation between vomiting and severity of toxicity, and between vomiting and outcome.
Kerosene ingestion may be associated with the development of fever (52.8%) and leukocytosis (26.6%), but may be with absence of clinically evident pneumonitis.
Respiratory manifestations were the commonest one (89.0%) followed by GIT (59%) and CNS (15.8%) manifestations.
The most common respiratory symptoms were cough (88.9%), difficulty of breath (39.4%). The most common signs were tachypnea (65.7%), nasal flaring (35.8%), wheeze (58.2%) and inter costal retraction (45.7%).
The GIT symptoms were usually mild and including vomiting (59.4%), diarrhea (6.6%) and abdominal distension (2.4%). Vomiting after kerosene ingestion affected the rate of development of pneumonia.
About 53 patients had symptoms and signs of CNS involvement included irritability (4.2%), lethargy (11.3%) and convulsions (1.5%). There was a highly significant relations between CNS ipairment and pneumonia, hypoxemia and fever. However, CNS toxicity can occur without concurrent pulmonary pathology.
Chest radiography revealed that the most common findings were increased broncho-vascular markings (45.1%) followed by pneumonia (29.0%) and only one patient had pneumothorax (0.3%). Bilateral pneumonia was the most common infiltrates (14.9%). There was highly significant statistical relation between vomiting and pneumonia.
Assessment of respiratory function by analysis of arterial blood gases (ABG) for 16 patients which revealed hypoxia in 8 patients and hypercapnia in 6 patients. Measurement of pH values revealed the occurrence of respiratory acidosis in 6 patients. ABG of the remaining patients were within normal range.
Treatment is mainly symptomatic and supportive, such as oxygen for (89.8%) of patients, intravenous fluids for (79.7%), antipyretic therapy for (37.1%) and (55.8%) of patients received nebulized bronchodilators, while (11.1%) of the patients treated with antibiotics because of suspected secondary infection. Only one patient (0.3) was treated with steroids.
According to the severity of toxicity, (2.4%) of patients were had no poisoning related symptoms or signs, (79.1%) of patients were of minor severity, (12.5%) were of moderate severity, (5.1%) of patients were of severe or life-threatening symptoms and fatal severity was determined in (1.2%) of patients.
According to the outcome, most of the patients (68.1%) were fully recovered, (1.2%) of patients died and the outcome of (30.7%) patients was unknown. There was a significant relation between the outcome and both of severity and hypoxia.
All the previously mentioned results of the present study were discussed and compared with other reviews in different countrie.