Lightning-strike-induced acute lung injury: a case report.

ABSTRACT

Lightning strike is an environmental electrical injury with high rates of morbidity and mortality. Lightning strike injuries are also considered to be high-voltage injuries. Respiratory injuries associated with lightning strikes include pulmonary edema, pulmonary contusion, acute respiratory distress syndrome, and pulmonary hemorrhage. In addition to direct damage, the affected patients are also exposed to secondary trauma; similarly, many other mechanisms associated with lightning injury have the same risk. It will therefore always be a rational approach to evaluate patients as multiple trauma patients. In this case report, a 19-year-old patient was admitted to the emergency department with amnesia, disorientation, shortness of breath, abdominal pain complaints and lung contusion, and myopathy signs as a result of a lightning strike in open terrain. The patient had a blood pressure of 80/50 mmHg, a heart rate of 110/min, and oxygen saturation of 85%. Bilateral lung contusion and pleural effusion were detected on the computerized tomography of the thorax. In addition, global cardiac hypokinesia and the 20%-25% ejection fraction were detected on echocardiography. The central nervous system and abdominal scans were normal. The patient was admitted to the intensive care unit and treated with supportive oxygen, intravenous hydration, antibiotics, systemic steroids, and invasive cardiac monitoring. On the 10th day of admission to the hospital, the patient was discharged with clinical and radiological improvement. On the 20th day after discharge, tomography scans showed no thoracic pathologic findings.