Isolated pulmonary injury following electric shock: a case report and literature review

Introduction and Importance: Electrocution can lead to severe visceral organ damage, including pulmonary injuries. However, isolated electrical-induced pulmonary injury (EIPI) following electric shock remains underreported. This case reports a 33-year-old male who suffered an EIPI after contact with low-voltage electricity and provides a comprehensive literature review to explore the mechanisms, clinical presentation, imaging findings, and treatment of EIPI. Case Presentation: A previously healthy 33-year-old male presented with dyspnea, chest pain, and dry cough following an electrocution while lifting a fallen 220 V wire. Chest imaging revealed diffuse consolidations, ground-glass opacities (GGO), and interlobular septal thickening. Bronchoscopy findings were normal; no infectious pathogens were detected in blood and sputum cultures. The patient was treated with oxygen therapy, antibiotics, and supportive care, achieving full recovery after 9 days of hospitalization. Clinical Discussion: A review of 12 case reports found that pulmonary injuries following electrocution are mostly associated with low-voltage exposure. The most common findings include bilateral lung consolidations, GGO, and diffuse alveolar hemorrhage. The pathophysiology of lung parenchyma involves coagulation necrosis, leading to alveolar hemorrhage. Management includes supportive care, with surgery reserved for cases with extensive necrosis unresponsive to medical treatment. Conclusion: EIPI is a rare but potentially severe consequence of electrocution, often presenting as bilateral lung consolidations and alveolar hemorrhage. Given the variability in presentation and severity, chest imaging should be considered in all cases after electrocution, even in the absence of external injuries. Early recognition and appropriate treatment are essential to ensure favorable outcomes, with surgical intervention considered in selected cases.