Persistent hoarseness after welding galvanized iron

Introduction

In addition to professional usage, the welding of ferrous metals is also becoming increasingly practiced among hobbyists thanks to inexpensive equipment. Protective gear against the resulting mechanical, thermal, radiation and toxic dangers are becoming an individual decision of untrained. If, for example, galvanized material is welded, toxic zinc oxide is formed, which leads to a respiratory and systemic disease – the metal fume fever. We report a case presented to us as "Laryngitis after exposure to metal fume".

Material and Methods

The 47-year-old farmer welded galvanized iron profiles to a tractor-trailer in a large but closed hall. The next morning, he woke up with a sore throat, hoarseness, productive cough, fatigue, and frequent choking. 3 weeks of antibiotic therapy followed. The hoarseness persisted, so the patient was presented to us 7 weeks after the event.

There were predominantly unspecific laryngitic changes. An antifungal therapy with fluconazole led to a rapid improvement of the previously stagnant symptoms, so that ex juvantibus a laryngeal mycosis was present.

Results

An unusual medical history and course led to the assumption of an unusual disease, metal fume fever with prolonged metal fume laryngitis. It remains unclear whether the initial symptoms were triggered by zinc oxide fume or simply a cold symptom. However, the long-lasting laryngitis after antibiotics was better explained by laryngeal mycosis than by zinc oxide.

Conclusion

A thorough medical history remains key to diagnosis. Sometimes, however, obvious information leads in the wrong direction.

Publikationsverlauf

Artikel online veröffentlicht:
24. Mai 2022