A 2-year, 2-month-old boy was admitted at an interval of 10 h with burns of 40% BSA (trunk, abdomen, legs, and hands) []. On admission, he was in gasping condition and was immediately intubated and ventilated. He had ventricular tachycardia, very poor perfusion, severe metabolic acidosis, and refractory hypotension. Postresuscitation, he was commenced on multiple inotropes. Similar to Case 2, he developed intravascular hemolysis with hemoglobinuria. Hemodialysis was initiated on D2, and because of hemodynamic instability, sustained low-efficiency dialysis was chosen as the modality. His liver function also worsened and needed N-acetylcysteine infusion with supports of various blood products. He also started having refractory convulsions which required multiple antiepileptic drugs. Both liver and renal function improved slowly. He was extubated at 9 days of mechanical ventilation, hemodialysis discontinued after 12 cycles, and ultimately discharged after 24 days of hospital stay. At 10-month follow-up, he is doing well with normal renal function, healing skin lesion, and mild neurological sequelae.
A 2-year-old girl was admitted within 2 h of accidental ingestion of carbolic acid with burn injury of about 8% of body surface area (BSA). Lips, tongue as well as part of the face, and chest were involved due to spillage, but pharynx and airway were spared. She was irritable and had drooling of saliva but no other systemic complications or airway-related issues. Glycerine was applied over the exposed skin as local therapy to prevent further absorption of carbolic acid. Initially, kept nil orally for 2 days and then started taking liquids followed by solids without any difficulty.