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Background <p>Acute<!--Query ID="Q1" Text="Please check if article title was captured correctly." Resolved="yes"--> severe nickel carbonyl poisoning is an uncommon<!--Query ID="Q2" Text="Please confirm if the author names are presented accurately." Resolved="yes"--> yet potentially fatal occupational hazard that produces marked pulmonary injury and rapidly progressive respiratory failure.</p> Case presentation <p>We describe three middle-aged men who developed severe nickel carbonyl intoxication after work<!--Query ID="Q3" Text="Please check if affiliations were captured and presented correctly. Otherwise, kindly amend if necessary." Resolved="yes"-->place exposure at a metal-processing facility. All patients presented with progressive dyspnea, cyanosis, hypoxemia, and pronounced neutrophilia. Chest computed tomography revealed bilateral pulmonary infiltrates with variable early distribution across patients. Prompt recognition permitted immediate initiation of high-dose methylprednisolone, moxifloxacin, and individualized supportive care according to oxygen (O<sub>2</sub>) requirements. All three patients exhibited striking clinical improvement within 72&#xa0;h. Serial imaging suggested substantial resolution of pul<!--Query ID="Q4" Text="Please check if the section headings are assigned to appropriate levels." Resolved="yes"-->monary inflammation, and every patient recovered without residual impairment.</p> Conclusions <p>Nickel carbonyl exposure<!--Query ID="Q5" Text="Please check abbreviation section if the provided description of the corresponding terms are captured correctly." Resolved="yes"--> demanded a high index of suspicion and prompt initiation of high-dose corticosteroid therapy was required to prevent irreversible lung injury and improve survival. This case series provides valuable clinical evidence to inform diagnostic and therapeutic approaches for this rare occupational poisoning.</p>

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High-dose corticosteroid application in acute severe nickel carbonyl poisoning: a case series of three occupational exposures and their recovery outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月15日

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  • Yixin Chen,
  • Zhuo Yang,
  • Yuqi Xiao,
  • Min Chai,
  • Hongwei Long,
  • Dahai Xu,
  • Chang Su

摘要

Background

Acute severe nickel carbonyl poisoning is an uncommon yet potentially fatal occupational hazard that produces marked pulmonary injury and rapidly progressive respiratory failure.

Case presentation

We describe three middle-aged men who developed severe nickel carbonyl intoxication after workplace exposure at a metal-processing facility. All patients presented with progressive dyspnea, cyanosis, hypoxemia, and pronounced neutrophilia. Chest computed tomography revealed bilateral pulmonary infiltrates with variable early distribution across patients. Prompt recognition permitted immediate initiation of high-dose methylprednisolone, moxifloxacin, and individualized supportive care according to oxygen (O2) requirements. All three patients exhibited striking clinical improvement within 72 h. Serial imaging suggested substantial resolution of pulmonary inflammation, and every patient recovered without residual impairment.

Conclusions

Nickel carbonyl exposure demanded a high index of suspicion and prompt initiation of high-dose corticosteroid therapy was required to prevent irreversible lung injury and improve survival. This case series provides valuable clinical evidence to inform diagnostic and therapeutic approaches for this rare occupational poisoning.