When curiosity turns toxic: accidental hydrocarbon aspiration in a pediatric patient - a case report with literature review

Accidental hydrocarbon ingestion is a common cause of pediatric toxic exposure, particularly among those under 6 years of age, and primarily causes injury through aspiration leading to chemical pneumonitis. Clinical presentation is variable, ranging from mild symptoms to severe respiratory failure, with potential early deterioration and rare delayed complications such as pneumatoceles. We report the case of a 17-month-old previously healthy boy admitted after accidental ingestion of printer fluid containing low-viscosity hydrocarbons. He initially presented with mild respiratory symptoms and stable vital signs but developed progressive chemical pneumonitis followed by delayed bilateral pneumatoceles within hours, requiring Pediatric Intensive Care Unit admission and ventilatory support with CPAP and subsequent HFNC. The clinical course was complicated by bilateral pulmonary consolidations and subsequent development of large pneumatoceles, with gradual radiological resolution and complete clinical recovery at 6- and 12-month follow-up, without residual sequelae. Our case illustrates that accidental hydrocarbon ingestion may lead to severe and progressive respiratory injury even after an apparently mild initial presentation, suggesting that prolonged observation may be warranted in selected patients with early respiratory symptoms or radiographic abnormalities. Although radiological complications such as pneumatoceles may develop several days after exposure, long-term outcomes are generally favourable, highlighting the remarkable capacity for pulmonary recovery in children and the importance of structured follow-up.