Carbon monoxide poisoning and pulmonary injury from the mixture of formic and sulfuric acids.

BACKGROUND

The inhalation of carbon monoxide produced by the incomplete combustion of carbon remains a popular method of suicide. A much less common method of producing carbon monoxide for suicide is by mixing formic and sulfuric acids.

METHODS

We describe a patient who attempted suicide by mixing formic and sulfuric acids. He presented with a depressed level of consciousness, chemical burns of his airway and skin, and respiratory distress. He was found to have a metabolic acidosis, a carboxyhemoglobin of 36.8%, hyperkalemia, and rhabdomyolysis. His hospital course was notable for copious pulmonary secretions and hypoxia, but he ultimately recovered with supportive care.

CONCLUSIONS

The case highlights the potential toxicity, particularly from inhaled carbon monoxide and formic acid, with this method of suicide.