Phenol Toxicity Following Cutaneous Exposure to Creolin®: A Case Report

Abstract

Introduction Phenol is a caustic that may cause cutaneous or gastrointestinal burns depending on the route of exposure. Significant absorption may result in systemic toxicity. We present a case of topical phenol exposure resulting in cutaneous burns and systemic phenol toxicity. Case report A 9-year-old girl was exposed to Creolin®, a general-purpose disinfectant containing phenol, when her mother applied this product to her head and upper torso. The patient required endotracheal intubation due to depressed mental status; she had cutaneous erythema in the distribution of contact with the cleanser. An initial EKG revealed sinus tachycardia with brief runs of monomorphic ventricular tachycardia. On hospital day (HD) 1, the area of erythema extended to both upper extremities and hyperpigmentation developed over the affected areas, which continued to darken during the hospital course. The patient was extubated late on HD 1. On HD 2, the patient's urine was noted to be a dark green color that resolved later that day. On HD 3, areas of desquamation and decreased sensation developed in skin areas of maximal contact with the cleanser. The patient developed a mild transaminitis with peak AST and ALT levels of 84 units/l and 99 units/l, respectively. The patient was discharged to home on HD 4. Discussion Our patient presented with signs of cutaneous and systemic phenol toxicity characterized by dermal burns, depressed mental status, cardiac dysrhythmias, and elevated hepatic transaminases. Phenol exposure may cause systemic toxicity following limited dermal exposure.

Creolin® administered by different pathways in rats experimentally poisoned with Bothrops jararaca venom

“…undesirable and harmful changes to animal health and lead to accidents involving cutaneous exposure in humans (VEARRIER et al, 2015). All animals that had contact with bothropic venom-regardless of the administration of Creolin ® -presented blood in the urine, most likely due to the hemolytic and myotoxic effects of venom (Table 1).…”

Experimental protocol to repel opossums (Didelphis marsupialis) through an artisanal odor repellent device

“…Creolin (CAS registry number 12751-04-1) is a natural disinfectant and an over-the-counter product mainly composed of phenol (17%). It is commonly used as antiseptic to clean wounds, bathrooms, and barns at low concentrations, although in higher concentrations can cause severe toxicity (Vearrier et al, 2015). This chemical was purchase from different labs, but all had the same phenol concentration, e.g., Fenolgan® produced by Fenolgan laboratory, or Específico® distributed by Rotam Agro Colombia.…”

“…Ammonia gasses can be very harmful to humans if lethal amounts are inhaled, they may cause larynx blocking and lungs distension and congestion (ATSDR, 2004). Creolin case is like ammonia in that exposure to phenol, its main constituent, may be rapidly absorbed through the skin, respiratory and digestive systems conducing to a systemic toxicity (Vearrier et al, 2015). Thus, like the effect of capsaicin (the active component of chili peppers) in some mammals (Norman et al, 1992;Smith et al, 1998), the repellent efficiency of ammonia and creolin in opossums was likely sensorial, and its efficiency may lie in that they produce irritation and short-term pain, its avoidance is immediate, no learning is required, and adaptation to learn its avoidance is minimal (Mason, 1998;Osborn and Parker, 2002).…”

Finding possible pharmacological effects of identified organic compounds in medicinal waters (BTEX and phenolic compounds)

“…These products are used for veterinarian, household cleaning and human delousing purposes. Even in the near past chemical burns caused by such products were reported (Vearrier et al 2015). Cosmetic surgeons use a type of deep chemical peel called phenol face peeling.…”

“…The local anaesthetic effect of phenol is used in peeling creams too (Ruiz-Maldonado 1997). Although acute phenol exposure can lead to severe symptoms, once recovered, long-term effects are not expected to appear (Vearrier et al 2015). Phenol peel is used today, but the protocols are strict and the applied products have lower side effect profile (Park et al 2007).…”