A hidden danger: lung abscess following inhalation of kerosene-based pyrethroid insecticide spray
Dublin Core
Title
A hidden danger: lung abscess following inhalation of kerosene-based pyrethroid insecticide spray
Subject
Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene
Description
Abstract
Background Pyrethroid insecticides are widely used because of their low toxicity in humans. Spray-type pyrethroids
are often formulated with kerosene as a carrier solvent, and inhalation of kerosene-containing products can lead
to pneumonitis and the formation of lung abscesses. We report a case of chemical pneumonitis resulting in the
development of a lung abscess due to the intentional inhalation of pyrethroids.
Case presentation A man in his 50s in a psychiatric hospital for transient psychotic disorder attempted suicide
during an overnight leave from the hospital. He drank sodium hypochlorite, put a nylon bag over his head, and
sprayed pyrethroid insecticide inside the bag. He was found collapsed and was transported to our emergency room.
On arrival, his SpO2 was 100% on O2 at 10 L/min by mask (100% on room air at ambulance arrival), his circulation
was stable, and his Glasgow Coma Scale score was 10 (E1V3M6), which improved to 15 (E4V5M6) in about one
hour. A chest computed tomography (CT) scan showed ground-glass shading in both lungs. We diagnosed him
as having pneumonia and started antimicrobial therapy. On day 13 of hospitalization, we found multifocal hypo-
absorptive areas, and a diagnosis of lung abscess was made based on CT imaging, and antimicrobial therapy was
continued. During the hospitalization, he expectorated bloody sputum. A contrast chest CT scan obtained on day 71
of hospitalization showed a pseudoaneurysm in the abscess cavity, for which we performed successful transcatheter
coil embolization. On day 77, the abscess was shrinking, and he was transferred to another hospital for continued
treatment. However, he again had bloody sputum and was transferred back to our hospital on day 113. Another
contrast chest CT scan revealed the formation of a new aneurysm, and on day 114, we successfully performed coil
embolization again, and he was transferred back to the other hospital on day 116.
Conclusion Spray-type pyrethroid insecticides contain the organic solvent kerosene. Inhalation of kerosene has
been reported in several cases of chemical pneumonitis leading to lung abscess. Clinicians should pay attention
to kerosene contained in insecticides and the circumstances under which they are used. Early recognition and
aggressive treatment can likely prevent severe outcomes.
Keywords Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene
Background Pyrethroid insecticides are widely used because of their low toxicity in humans. Spray-type pyrethroids
are often formulated with kerosene as a carrier solvent, and inhalation of kerosene-containing products can lead
to pneumonitis and the formation of lung abscesses. We report a case of chemical pneumonitis resulting in the
development of a lung abscess due to the intentional inhalation of pyrethroids.
Case presentation A man in his 50s in a psychiatric hospital for transient psychotic disorder attempted suicide
during an overnight leave from the hospital. He drank sodium hypochlorite, put a nylon bag over his head, and
sprayed pyrethroid insecticide inside the bag. He was found collapsed and was transported to our emergency room.
On arrival, his SpO2 was 100% on O2 at 10 L/min by mask (100% on room air at ambulance arrival), his circulation
was stable, and his Glasgow Coma Scale score was 10 (E1V3M6), which improved to 15 (E4V5M6) in about one
hour. A chest computed tomography (CT) scan showed ground-glass shading in both lungs. We diagnosed him
as having pneumonia and started antimicrobial therapy. On day 13 of hospitalization, we found multifocal hypo-
absorptive areas, and a diagnosis of lung abscess was made based on CT imaging, and antimicrobial therapy was
continued. During the hospitalization, he expectorated bloody sputum. A contrast chest CT scan obtained on day 71
of hospitalization showed a pseudoaneurysm in the abscess cavity, for which we performed successful transcatheter
coil embolization. On day 77, the abscess was shrinking, and he was transferred to another hospital for continued
treatment. However, he again had bloody sputum and was transferred back to our hospital on day 113. Another
contrast chest CT scan revealed the formation of a new aneurysm, and on day 114, we successfully performed coil
embolization again, and he was transferred back to the other hospital on day 116.
Conclusion Spray-type pyrethroid insecticides contain the organic solvent kerosene. Inhalation of kerosene has
been reported in several cases of chemical pneumonitis leading to lung abscess. Clinicians should pay attention
to kerosene contained in insecticides and the circumstances under which they are used. Early recognition and
aggressive treatment can likely prevent severe outcomes.
Keywords Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene
Creator
Kohei Ofune1
, Tomoya Hirose1*, Hiroki Kai1
, Yoshinori Yokono1
, Ryosuke Takegawa1
and Jun Oda1
, Tomoya Hirose1*, Hiroki Kai1
, Yoshinori Yokono1
, Ryosuke Takegawa1
and Jun Oda1
Source
https://doi.org/10.1186/s12245-025-00829-z
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Kohei Ofune1
, Tomoya Hirose1*, Hiroki Kai1
, Yoshinori Yokono1
, Ryosuke Takegawa1
and Jun Oda1, “A hidden danger: lung abscess following inhalation of kerosene-based pyrethroid insecticide spray,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12662.