Trichloroethylene Intoxication: A Case of Acute Altered Mental Status Which Required Intensive Resuscitation

Background: Trichloroethylene is a hydrocarbon commercially used as a degreasing solvent. It has gradually become obsolete due to is carcinogenic properties meanwhile, many industries still use it due to its cost effectiveness. Although there are reports and studies regarding chronic exposures to trichloroethylene there are very few acute cases reported that have caused altered mental status and required intensive care. This paper aims to report the course of an acute case of trichloroethylene intoxication with coma and summarize its characteristics. Case Presentation A 50-year-old male with no particular medical history presented with acute altered mental status due to inhalation of volatile trichloroethylene in a factory. He was given brief cardiopulmonary resuscitation for suspected cardiac arrest however was found to have a pulse when emergency medical services had intervened. On arrival to our emergency department, he showed marked central nervous system depression due to suspicion of acute trichloroethylene intoxication. Head computed tomography showed no signs of hypoxic ischemia encephalitis, however the possibility of loss of consciousness from a cardiac event could not be denied. The patient was intubated promptly, elicited by impending respiratory arrest and received supportive treatment. Trichloroethylene metabolite urinary concentrations were taken during admission. He regained consciousness readily, was extubated the next day and then discharged, showing full recovery on day 3. Conclusion: We reported a case of acute trichloroethylene intoxication which required intensive care but was discharged with full recovery and no neurological deficits. There have been few reports describing acute intoxication which needed intubation and its neurological outcomes. Furthermore, this report suggests urine metabolite concentration as a possible guide to predict clinical outcome.