The clinical manifestations of hydrocarbon poisoning depend on the route and amount of the exposure. Patients may present asymptomatically or in fulminate respiratory distress. Many fall on a continuum between the two.
Coughing, gagging, choking, and vomiting after an ingestion of a hydrocarbon is presumptive of aspiration. Signs of pulmonary toxicity may include tachypnea, crackles, bronchospasm, hemoptysis, hypoxia, acute lung injury, or respiratory failure. The respiratory signs typically progress over one to several days and then resolve. Fortunately death is rare.
The radiographic findings of pulmonary toxicity are protean. They range from increased bronchovascular markings to consolidation. There may be involvement of one lobe or segment or multilobular findings.
The cardiac findings range from mild tachycardia to ventricular tachydysrhythmias. Victims of sudden sniffing death syndrome may present in full cardiac arrest. Myocardial depression may also occur.
The typical CNS finding is mental status depression, although this may be preceded by a brief period of CNS excitation. The CNS depression may be profound. Seizures have also been reported. Chronic volatile hydrocarbon abuse has been associated with a leukoencephalopathic syndrome that can include neurobehavioral abnormalities such as ataxia and dementia.9,10