VOLUME 15 (Supplement)

Chronic arsenic poisoning presenting with widespread bronchiectasis – A case report

Chronic arsenic poisoning can cause a variety of symptoms, most commonly reported of which are dermatologic and neurologic symptoms but pulmonary complications have also been reported. In this case report, we present a 17-year-old male who came from Lubao, Pampanga where there are known cases of chronic arsenic poisoning from a previously identified water source. The patient complained of chronic cough, bipedal edema, and difficulty in breathing. On admission, the patient was tachypneic, tachycardic, and with peripheral oxygen saturations as low as 70-80% on room air. The patient had digital clubbing, multiple hyperkeratotic papules on the palms and soles, and melanosis more on the lower extremities. Other family members also had the same skin lesions but did not present with respiratory complaints. Arsenic levels were determined from urine and bronchoalveolar lavage samples which were both low. Chest imaging showed extensive bronchiectasis in both lungs.