The Drug-Induced Respiratory Disease Website

Chlorine gas (dichlorine: Cl2)

Bronchiolitis (a clinical-imaging pattern suggestive of)

Including a tree-in-bud appearance on HRCT

Na W, Wang Y, Li A, Zhu X, Xue C, Ye Q

Acute chlorine poisoning caused by an accident at a swimming pool.

Toxicology and industrial health 2021 Aug 03;;7482337211019180 — 2021 Aug 03 — 7482337211019180

Parimon T, Kanne JP, Pierson DJ

Acute inhalation injury with evidence of diffuse bronchiolitis following chlorine gas exposure at a swimming pool.

Respiratory care 2004 Mar;49;291-4 — 2004 Mar — 291-4

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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