# Three Cases of Chemical Burns Caused Due to Dimethyl Sulfate Poisoning

## TL;DR

Three workers suffered chemical burns from dimethyl sulfate exposure, requiring emergency airway interventions despite initially mild symptoms.

## Contribution

Highlights the delayed severity of dimethyl sulfate poisoning and the need for careful monitoring and airway management.

## Key findings

- Three patients developed laryngeal edema requiring tracheostomy or intubation after DMS exposure.
- Steroids improved symptoms, but one patient needed extended treatment.
- Initial mild symptoms can progress to severe complications from DMS poisoning.

## Abstract

Dimethyl sulfate (DMS) is a drug widely used as a pharmaceutical and synthetic raw material. On the other hand, it is highly toxic and requires management and treatment as a hazardous substance.

A mass outbreak of chemical burns resulting from DMS poisoning occurred at a drug factory. All three patients were brought to our hospital, a tertiary emergency medical facility, several hours after exposure. Their vital signs were stable, with only eye pain and a sore throat. However, after admission, two patients required emergency tracheostomy or endotracheal intubation due to laryngeal edema. Improvement was achieved through the administration of steroids, but a severely injured patient required an extended treatment period.

DMS poisoning is rare; however, it can be fatal depending on the exposure concentration. Furthermore, even if the initial symptoms are mild, laryngeal edema may develop later, requiring careful monitoring and appropriate airway interventions.