Delayed aspiration pneumonia and systemic toxicity in patient who inhaled dry powder of fire extinguisher

A 45-year-old man inhaled fire extinguisher powder. After three days of asymptomatic period, respiratory symptoms and systemic toxicity developed. Patient had cardiac arrest in the emergency department and was successfully resuscitated. The dry fire extinguisher powder contains high concentrations of monoammonium phosphate, which causes severe hyperphosphataemia and hypocalcaemia. Life threatening conditions such as seizures, cardiac arrhythmias, acidosis, and cardiac arrest can develop. When monoammonium phosphate was inhaled, only mild flu-like symptoms can present initially. Therefore, primary physicians need to be aware of the entity and clinical severity of intoxication to achieve early recognition and treatment.