A case of anionic surfactant poisoning causing persistent upper airway narrowing and swallowing dysfunction

Abstract

Many laundry detergents include anionic surfactants and cases of causing laryngeal edema have been rarely reported after ingestion. Here, we present the case of a 44-year-old male patient who developed anionic surfactant-induced laryngeal edema after ingesting 25 g of a laundry detergent with a surfactant concentration of 51％, including hydroxy- alkane sulfonate, polyoxyalkylene alkyl ether sulfates, fatty acid salts, and polyoxyalkylene alkyl ethers, and developed sore throat, vomiting, and diarrhea. He was transferred to the hospital 3 h after poisoning, and supraglottic edema was observed at arrival. The patient was intubated and admitted. On day 4, tracheotomy was performed to secure the airway due to laryngeal edema. He experienced decreased pharyngeal sensation and was initiated on swallowing rehabilitation on day 7. The tracheotomy tube was removed on day 35, and the patient was discharged on day 44. Even a small amount of high-concentration anionic surfactants can lead to upper airway narrowing due to laryngeal edema and swallowing disorder due to decreased sensation. Securing the airway and early rehabilitation should be considered in patients with oral ingestion of anionic surfactants.