Severe acute respiratory distress syndrome caused by uninten
Sewing machine lubricant is a type of hydrocarbon which is easily available at home and thus is a potential source of poisoning.[1] It is different from other domestic hydrocarbon products by the fact that it has got relatively high viscosity and low volatility.[2] These properties make its aspiration potential and toxicity low if ingested. We report a case of a 5-year-old girl with accidental sewing machine oil ingestion who developed severe toxicity with subsequent hypoxemic respiratory failure developing acute respiratory distress syndrome (ARDS). The mechanism of injury results from direct toxicity to pulmonary parenchyma and disruption of the surfactant layer.[3] To the best of our knowledge, severe ARDS from sewing machine oil ingestion has not been reported previously.

Case Report
A 5-year-old girl came to our emergency room with 4–5 episodes of nonbilious vomiting, fever, and fast breathing for 1 day. She was irritable (Glasgow Coma Scale-9) and had severe respiratory distress. She had a heart rate-126/min, respiratory rate-60/min, subcostal and intercostal retractions, blood pressure-94/60 mmHg, SpO2-78% on room air and 86% on oxygen flow 5 l/min. There were bilateral crepts in chest and a soft liver measuring 3 cm in abdomen. She was immediately stabilized with oxygen and fluids and was shifted to Pediatric Intensive Care Unit in view of increased work of breathing and hypoxemia....