International Journal of Head and Neck Surgery

Register      Login

VOLUME 5 , ISSUE 3 ( September-December, 2014 ) > List of Articles


Acute Formic Acid Poisoning: A Case Series Analysis with Current Management Protocols and Review of Literature

MK Goutham, Ravishankar S Bhat, CR Bhat, Mohan Appaji, KV Chidananda, Nongthomban Pinky Devi, Sherry Joseph, Pooja Nayak

Citation Information : Goutham M, Bhat RS, Bhat C, Appaji M, Chidananda K, Devi NP, Joseph S, Nayak P. Acute Formic Acid Poisoning: A Case Series Analysis with Current Management Protocols and Review of Literature. Int J Head Neck Surg 2014; 5 (3):104-107.

DOI: 10.5005/jp-journals-10001-1193

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2014; The Author(s).



Formic acid (FA) being pungent, odorless, easily available and consumed for suicidal purposes and the dilute form being colorless and odorless is consumed accidentally. Accidental ingestion is rare and deliberate self-harm is very painful and violent which has been a rare modality of committing suicide but for these areas where it is easily available.

Materials and methods

This a retrospective case series analysis study 14 patients with acute formic acid poisoning. There were 14 patients, with 3 females and 11 males. The average age was 35.5 years, with the average in males being 34.9 and 37.6 in females. Thirty milliliter were considered as cutoff range as diluted/undiluted FA below 30 ml were managed in our institution and 30 ml+ were referred to higher toxicology speciality care.


Act of deliberate self-harm was seen in 11 cases (78.5%) and accidental ingestion in three cases (21.5%). All had orofacial burns, 4 had mild hematemesis and 3 severe hematemesis with impending renal complications. All the stabilized and referred cases were no further evaluated for follow-up. Facial burns and contracture needing cosmetic correction was seen in three cases, while corneal and lid scarring seen in two cases while a case of esophageal stricture with lower GIT and renal complications were seen in one case.


Formic acid poisoning is uncommon, and limited literature review is available with fewer protocols laid. So, immediate management of this corrosive poisoning with supportive measures reduces the mortality drastically. Serial upper gastrointestinal imaging diagnose stricture earlier and cosmetic reconstruction helps in facial scarring and contractures.

How to cite this article

Bhat RS, Naik SM, Goutham MK, Bhat CR, Appaji M, Chidananda KV, Devi NP, Joseph S, Nayak P. Acute Formic Acid Poisoning: A Case Series Analysis with Current management Protocols and Review of Literature. Int J head Neck Surg 2014;5(3):104-107.

PDF Share
  1. Formic acid poisoning with sui cidal intent: areportof 53 cases. Postgrad Med J 1985 Jan;61(711):35-36.
  2. Formic acid poisoning in a tertiary care center in south india: a 2-year retrospective analysis of clinical profile and predictors of mortality. J Emerg Med 2013;44(2):373-380.
  3. Formic acid intoxications. Acta pharmacologica et toxicologica (Suppl) 1977;41(6):342.
  4. Acute accidental formic acid poisoning: a common problem reported in rubber plantations in sullia. Int J Head Neck Surg 2012 May;3(2):101-105.
  5. Formic acid burn-local and systemic effects: report of a case. Burns 1983; 9(1):358-361.
  6. Ingestion of formic acid-containing agents: report of three fatal cases. Postgrad Med J 1980 June;56(656):451.
  7. Formic acid poisoning. J Ind Acad Foren Med 1991;13(2):29-31.
  8. Formic acid skin burns resulting in systemic toxicity. Annals of Emergency Medicine 1995;26(3):383-386.
  9. Death due to adult respiratory distress syndrome following assault with rubber acid: could it have been averted? Sri Lanka J Forensic Med Sci Law 2012 May;3(1).
  10. Acute formic acid poisoning in a rubber plantation worker. Ind J Occupational and Environ mental Med 2014 Jan-Apr;18(1):29-31.
  11. Ocular and systemic morbidity profile in mass formic acid injuries. Ophthalmic Surg Lasers Imaging 2010;41(2):123-127.
  12. Chemical pneumonitis following household exposure to hydrofluoric acid. Am J Indust Med 1997;31(4):474-478.
  13. An evaluation of steroids and antibiotics in corrosive burns of esophagus. Ann Thoracic Surg 1970;9(1):95-102.
  14. Fatal intoxication with a decalcifying agent con taining formic acid. Int J Legal Med 2001 Feb;114(3):181-185.
  15. Protein loss in peritoneal dialysis. Lancet 1964 Apr;1(7336):738-741.
  16. Corrosive burns of the esophagus and stomach: a remainder for aggressive surgical approach. Ann Thoracic Surg 1986 Mar;41(3):276-283.
  17. Formic acid and enhanced renal elimination in formic acid intoxication. Clinical Toxicol 1994;32(3):199-204.
  18. American academy of clinical toxicology ad hoc committee on the treatment guidelines for methanol poisoning. J Toxicol Clin Toxicol 2002;40(4):415-446.
  19. Acute formic acid poisoning in south India, postcards from Beijing: annual meeting abstracts. J Med Toxicol 2010;6(3):361.
  20. Formic acid poisoning. Postgrad Med J 1980;56(2):761-762.
  21. Acute effects of exposure to vapours of acetic acid in humans. Toxicology Letters 2006;165(3):22-30.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.