Fatal transcutaneous iron intoxication.

Accidental iron intoxication is one of the most serious and potentially fatal intoxications in young children. Occurrence in the adult population is rare and is usually associated with a suicide or homicide attempt. Heretofore, all reported cases have involved oral ingestion of ferrous and ferric salts of iron. In a case of fatal iron intoxication reported by Doolin and Drueck, in addition to swallowing a liquid form of ferrous chloride, the patient aspirated it and absorbed it through chemically burned and denuded areas of skin when he fell into a vat of saturated ferrous chloride at work. It is the purpose of this report to describe the first case of fatal iron intoxication in which the sole route of iron absorption was the burned skin. Clinical course of this patient paralleled that of acute oral iron intoxication with development of refractory acidosis, disseminated intravascular coagulation, respiratory and renal failure, and sepsis.