Low-voltage electricity-induced lung injury

Abstract

We report a case of bilateral pulmonary infiltrates and haemoptysis following low-voltage electricity exposure in an agricultural worker. A 58-year-old man standing in water reached for an electric watering machine and sustained an exposure to 220 V circuit for an uncertain duration. The electricity was turned off by another worker, and the patient was asymptomatic for the next 10 h until he developed haemoptysis. A chest radiograph demonstrated bilateral infiltrates, and chest computed tomography (CT) revealed ground-glass opacities with interstitial thickening. Evaluations, including electrocardiogram, serum troponin, N-terminal pro-B-type natriuretic peptide (NT-pro BNP), coagulation studies, and echocardiogram, found no abnormality. The patient was treated for suspected electricity-induced lung injury and bleeding with tranexamic acid and for rhabdomyolysis with volume resuscitation. He recovered with complete resolution of chest radiograph abnormalities by Day 7. This is the first reported case of bilateral lung oedema and/or injury after electricity exposure without cardiac arrest.

Keywords: Electrical visceral injury; haemoptysis; lung necrosis; pulmonary oedema; rhabdomyolysis.

Figure 1

(A) Initial chest radiograph demonstrates heterogeneous opacities in both lungs. (B) Chest radiograph performed on day 7 shows complete resolution of the opacities.

Figure 2

Chest computed tomography (CT) scan demonstrates perihilar ground‐glass opacities of both lungs with right upper lobe predominance, thickening of interlobular septa and intralobular lines, and diffuse bronchial wall thickening.