TITLE:
Chloramine Intoxication in a Five-Month Pregnant Patient: A Case Report
AUTHORS:
Niels Oversteyns, Hans De Puydt, Stefanie Vandervelden
KEYWORDS:
Chloramine Intoxication, Acute Non-Cardiogenic Pulmonary Edema, Pregnancy
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.14 No.11,
November
6,
2025
ABSTRACT: Chloramine inhalation resulting from the accidental mixing of bleach and ammonia is a potentially life-threatening intoxication, as it may lead to severe respiratory compromise. The majority of case reports on intoxication with chlorine-containing substances focus exclusively on chlorine inhalation, and no cases involved pregnant patients. We present a case of a 27-year-old, five-month pregnant biologic female who experienced acute respiratory distress due to non-cardiogenic pulmonary edema after cleaning her bathroom with bleach in combination with ammonia. Initial management included removal from exposure, supplemental oxygen, non-invasive ventilation via Continuous Positive Airway Pressure (CPAP) and methylprednisolone IV, resulting in rapid clinical improvement. Fetal monitoring remained reassuring throughout hospitalization. The patient was observed for 24 hours and discharged in stable condition. Management of chloramine intoxication is primarily supportive, with limited evidence for bronchodilators, corticosteroids, or nebulized sodium bicarbonate. In pregnant patients, maternal stabilization and continuous fetal monitoring are essential. Observation for 24 hours is advised, with follow-up to monitor for potential chronic pulmonary sequelae.