2. Patient information
• Name: John
• Age: 32 years
• Sex: Male
• Occupation: chemical technician
• Marital status: unknown
• Employment history: 8 years in a pesticide
manufacturing plant
• Date of evaluation: 27.02.24
3. Complaints:
• Nausea, Dizziness, headache
• Shortness of breath, cough
• Increased temperature
• Generalised weakness
• Redness, itching and burning on hand
4. Anamnesis
Occupational Anamnesis:
Patient works at a pesticide manufacturing company
for 8 years
Symptoms started after there was an accidental spill
of a Chlorogenic Substance at the factory.
Patient was exposed to the chemical for about 30
mins. It fell on the patient's hand and he Also inhaled
it.
He describes immediate Symptoms of nausea and
dizziness, progressed to shortness of breath.
5. Anamnesis
• Anamnesis of Life:
• No history of respiratory illnesses, allergies or
chronic conditions
• Patient doesn't smoke or drink
• No prior incidents of acute Chemical intoxication at
work
6. Objective Exam
• blood pressure 120/80 mmHg
• Heart rate 80 BPM
• Respiratory Rate 21 BPM
• Temperature 38°c
• SpO2 96%
• Patient appears distressed, oriented
• Signs of central cyanosis
• lung auscultation Has decreased breath sounds, no
wheezing
• No Murmurs on heart
8. Investigations:
• Laboratory Exams:
• Complete blood count - leucopenia, lymphocytosis,
elevated ESR
• Biochemical analysis - mild hypocalcemia,
hyperkalemia
• ALT, AST are in normal range.
• ECG shows no conduction abnormalities
• gas chromatography mass Spectrometry confirmed
the presence of chlorogenic substance in blood.
9. • chest X ray is normal, no abnormalities in lungs
• Spirometry revealed mild decrease in FEV1
• Differential Diagnosis:
• bronchial asthma
• Pneumonia
• Acute bronchitis
10. Clinical Diagnosis
• Based on occupational history, results of laboratory
Exams and Chromatography Findings:
• Acute intoxication with Chlorogenic Substance -
mild form
• Etiology - occupational exposure with the chemical
during an accident by inhalation and dermal
contact
11. Treatment:
• Cleaning of skin with sodium hydrocarbonate
solution
• Albuterol 5mg IV
• Ipatropium Bromide 2mg IV
• Nebulised lidocaine 2%
• Supplemental Oxygen Therapy
• Intravenous Calcium, electrolytes
• Acetaminophen 5g orally
• Chlorpromazine 10mg orally
• IV vitamin B group with ascorbic acid
12. Prophylaxis and Prognosis
• Implementation of safety protocols
• Usage of PPE kits during working hours
• Limiting exposure with the substance
• Seeking immediate medical help in case of
exposure.
• Prognosis in this case is favourable, symptoms
should resolve in a 3-4 days. Working capacity is
not affected.
