kerosene is refined oil belonging to the hydrocarbon group of compounds , obtained from crude petroleum .
poisoning is due to inhalation of fumes or ingestion of small amounts accidentally ( children ) or most of the cases reported in the literature were self - inflicted with the intention of committing suicide which constitutes significant emergency admissions .
a 34-year - old male patient presented to our out - patient department with a history of injecting about 5 ml of kerosene to his left hand at two sites following an argument with his family members 2 days prior to presentation , with an intention to commit suicide .
after 2 days , the pain became intolerable leading to disturbed sleep , with multiple blisters and swelling of the left hand .
no other significant medical history was noted . on examination , he was an alert middle - aged man , moderately built and nourished , and well oriented to time , place , and person .
multiple vesicles and blisters were present over the left forearm and few over the dorsal aspect of the left hand .
black discoloration extending from the hand up to the lower third of the arm was present .
local rise of temperature and tenderness was present from the hand up to lower third of arm .
refilling could not be elicited [ figures 1 and 2 ] . multiple vesicles and blisters
black discoloration extending from the hand up to the lower third of the arm was present .
patient was unable to flex the hand few vesicles , blisters , and erosions were present over the dorsal aspect of the left hand there were no other lesions .
irritant contact dermatitis the patient was admitted to the ward ; intravenous ( iv ) amoxycillin with clavulinic acid , iv steroid , and iv fluids were started .
iv or subcutaneous self - injections of commercial gasoline or kerosene with suicidal intent constitute extraordinary events in psychotic patients .
the lethal dose of kerosene for a 70 kg adult is 100 ml . in 1977 ,
green first described a patient who survived a 3 ml iv injection of energine , a derivate of kerosene .
this patient developed lethargy , drowsiness , and a sterile abscess at the injection site without other systemic effects .
our patient had injected 5 ml of kerosene and developed lesions over the forearm , as described .
neeld and vaziri each reported a case of iv injection of petroleum distillate that caused severe chemical pneumonitis . in both cases , pulmonary edema and hypoxemia developed , and in one , the patient suffered abrupt respiratory arrest immediately after injection .
kosa reported an accidental iv injection of 10 ml of gasoline that resulted in a fatal outcome .
the case strongly suggested that hydrocarbons , as low - viscosity chemical compounds , have a direct toxic effect on lung tissue , interfering with gas exchange and leading to liquid interstitial pulmonary edema and severe hypoxemia caused by impaired diffusion .
other effects of hydrocarbon intoxication include acute renal damage with oliguria , hepatocellular damage , intracellular hemolysis , gastric ulcers , and cardiac toxicity with negative inotropism .
a case of self - inflicted acute necrotizing fasciitis with compromised venous return secondary to injection of kerosene was reported .
a study on the clinical findings and outcome in suicide attempts by iv injection of kerosene among iv drug abusers was done in iran .
although kerosene is a easily available refined oil as it is used for household purposes , poisoning occurs by inhaling fumes and ingestion accidentally in children and with the intention of committing suicide in adults .
kerosene injection can produce severe tissue damage , especially if prompt surgical treatment is delayed .
therefore , it is important to initiate active and immediate surgical intervention in the form of complete multiple fasciotomies , incision , and surgical excision of non - viable tissue .
it should also be followed by active and repeated aggressive wound debridement until healthy granulation tissue is formed .
 kerosene is refined oil belonging to the hydrocarbon group of compounds , available for domestic use in developing countries . 
 poisoning is due to inhalation , ingestion . kerosene . 
 we report a rare case of attempted suicide by means of intravenous injection of kerosene . 
 it has a devastating effect and it is important to initiate active and immediate surgical intervention . 
 psychotherapy should also be an integral part of the management . 
INTRODUCTION
CASE REPORT
DISCUSSION
CONCLUSION