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White Phosphorus Burns and Arsenic Inhalation: A Toxic Combination

Berndtson, Allison E. MD*; Fagin, Alice MD*†; Sen, Soman MD*†; Greenhalgh, David G. MD, FACS*†; Palmieri, Tina L. MD, FACS, FCCM*†

Journal of Burn Care & Research:
doi: 10.1097/BCR.0b013e31828c73dd
Case Reports
Abstract

White phosphorus is a common industrial and military compound, which can cause severe thermal and chemical burns beyond what would be predicted from body surface area alone. The authors present a rare case of a 45-year-old male patient who suffered white phosphorus burns combined with arsenic inhalation because of an industrial accident. The presented case is used to review the history and the toxicities of these chemicals as well as current methods of treatment. A literature review was performed to summarize the current knowledge of white phosphorus burns, as well as arsenic poisoning, and no similar case reports of the two combined were found. The patient ultimately recovered and was discharged, though with significant chronic complications. This case highlights the risk of burns and inhalation injury present in industrial manufacturing jobs, as well as the potential severity of these conditions. The systemic effects of chemicals absorbed across burned skin and via inhalation were the main contributors to our patient’s severe illness, and required more intensive treatment than the burns themselves. Arsenic toxicity is rare and could easily have been missed without the appropriate patient history.

Author Information

From the *Department of Surgery, University of California-Davis; and Department of Burn Surgery, Shriners Hospitals for Children—Northern California, Sacramento.

Address correspondence to Tina L. Palmieri, MD, FACS, FCCM, 2425 Stockton Blvd, Sacramento, California 95817.

© 2014 The American Burn Association