Accidental intoxication by dichloromethane at work place: Clinical case and literature review

Introduction Dichloromethane, also known as methylene chloride, is an organic solvent used in various industrial applications. Exposure to DCM can result in toxicity caused by either the direct effects of DCM or by its metabolite, carbon monoxide. Clinical case A 27-year-old man, a worker in a paint-stripping factory, fell down in a well having suffered immediate loss of consciousness. He was sedated, intubated, and transported to the hospital. Hospital blood gas showed severe metabolic acidosis and increased levels of carbon monoxide – FCOHb 23,9%. A chest radiograph showed bilateral heterogeneous pulmonary infiltrates. The analysis of the chemicals present in the wells revealed dichloromethane with concentration > 50%. Hyperbaric oxygen therapy was performed, and the patient was discharged after a total of 10 days of hospitalization, without sequelae. Conclusion Initial clinical suspicion and rapid confirmation of poisoning by dichloromethane is crucial, given that the speed of action and the institution of appropriate therapy can determine the patient prognosis.