Formic acid is a serious chemical and not to be trifled with

CASE REPORT

While playing near her grandfather's leather-tanning
workroom, a 3-year old girl was exposed to 90% concentrated
formic acid. Her mother found the child running
from the workroom with grayish material over her right
torso and extremities. Paramedics arrived within 10 minutes
and washed the child with water from an outdoor
hose. The child was then transported to the regional burn
center.

Skin contact can result in deep tissue burns and coagulative
necrosis similar to that caused by other acid burns.
These injuries may be overlooked and are often more significant
than they first appear. Removal of clothing
and immediate vigorous irrigation are of primary importance
on presentation. Treatment and complications
are similar to those of other acid burns.

We report a case of severe systemic toxicity resulting from
formic acid skin burns in a 3-year-old girl. She presented
with a profound anion gap metabolic acidosis, and other
complications developed as a result of systemic absorption,
but she was successfully treated with IV fluids, bicarbonate,
and hemodialysis. 

Despite limited reports of
formic acid poisoning in the literature, clinicians should
be aware of this toxic substance because industrial and
domestic use of formate is increasing. Treatment should
focus on correction of the acidosis, which plays a major
role in toxicity, and removal of formic acid from the body.

Formic Acid Skin Burns Resulting in Systemic Toxicity
From the Department of Emergency Medicine, University of California, San Diego, Medical Center.
SEPTEMBER 1995 26:3 ANNALS OF EMERGENCY MEDICiNE

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