When your lungs get cleaned by Harpic: A case report

INTRODUCTION: The use of household cleaning agents as a method of self-harm has been reported in the literature frequently. However, reports of Harpic ingestion a commonly used toilet cleaner is significantly lacking. Due to the ease of access of household cleaning agents, people tend to choose it as quick method of self-harm. The main focus after ingestion of acid is on the digestive tract injury. But due to the tendency to vomit after ingestion of such substance and inhalation of fumes generated there is a high possibility of injury to the respiratory tract as well. CASE PRESENTATION: Here we present a case of 19-year-old female with injury to the aerodigestive tract presenting with stridor after ingestion of Harpic - a hydrochloriacid-based cleaning solution. In addition to the gastric mucosal injury a diagnosis of chemical pneumonitis was made and her airway was protected in time for her to have a good recovery. DISCUSSION: Inducing vomiting in patients with hydrochloric acid is not advised because it can increase the risk of pulmonary complications as a result of aspiration [8]. Moreover, blind insertion of a nasogastric (Ryle's) tube is not done due to the risk of perforation and induction of regurgitation or vomiting. In few cases steroids have also been tried with no promising results [9]. Since there are no therapeutic standards for caustic injuries, treatment centers on correcting metabolic imbalances, coagulopathy, and emergency surgical intervention for severe injury and late sequelae. However, it is crucial to watch out for aspiration and respiratory tract injury and perform timely protection of the airway. CONCLUSION: An awareness of the potential impacts of acid ingestion on the respiratory tract with a high level of suspicion towards airway injury and timely protection of airway is crucial for proper management of the patient.