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Ref Number = PITIKA-ASPR0026
CHEST X-RAY AS PREDICTION OF SEVERITY AND FOLLOW UP FOR SUCCESSFUL MANAGEMENT OF KEROSENE POISONING IN PRIMARY HOSPITAL.
Yola Yuniaarti Herijanto, Melissa Adriani Tjahyadi, Djiu Wina, Irene Hintanputung
Kerosene ingestion in children is commonly found in developing countries since it’s used for many household activities. Dyspnea, cough, tachypnea are the most common manifestations of kerosene poisoning. Blood gas analysis (BGA) was useful to predict the outcome of kerosene poisoning. In primary hospital with no facility of BGA examination, Chest X-Ray (CXR) is very useful to predict the outcome of the disease. Oxygen, hydration and supportive treatment are the main therapies of kerosene poisoning. The use of antibiotics is still controversial. We present a case of kerosene poisoning in primary hospital focus on diagnosis and management.
OBJECTIVE: To show which laboratory examinations that is useful to predict the severity and follow up for successful management of kerosene poisoning in primary hospital.
 CASE: One-and-a-half-year-old boy unintentionally ingested kerosene 3 hours prior to admission. The patient presented with vomiting, respiratory distress and shock. He was admitted to Intensive Care Unit. Chest X-Ray finding revealed bilateral perihilar infiltrates and pericardial infiltrates, suggesting of aspiration pneumonia. Complete Blood Count showed that white blood cell increased to 17,400 /mm3. Oxygen, hydration and supportive treatments were immediately given. Antibiotics injection of ampicillin, metronidazole and oral clindamycin were given. Repeat CXR on day 3 and 5 of treatment showed an improvement. After 7 days of treatment, there was no signs of respiratory distress and other complications so the patient was discharged.  
CONCLUSION: Chest X-Ray is the most useful laboratory examination to predict the outcome of kerosene poisoning in hospital that do not have BGA examination facility. 
Keywords: Children, diagnosis, kerosene poisoning, management
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