Toxicology International, Jan-April 2016 / Vol-23 / Issue-1, 100-103 * Author for correspondence ISSN (Print) : 0971-6580 ISSN (Online) : 0976-5131 DOI: 10.22506/ti/2016/v23/i1/146679 Case Report 1. Introduction Ammonia is a colorless irritant gas with a pungent odour. In industry it is used in mining, plastic, explosives and refrigerants etc. 1 About 80% of the ammonia produced by industry is used in agriculture as fertilizer. In pure form it is known as anhydrous ammonia and is hygroscopic. It has alkaline properties and is corrosive. Ammonia gas is easily compressed and forms a clear liquid under pressure. 2 Most people are exposed to ammonia from inhalation of gas or vapors. he wide spread use of ammonia on farms, industry and commercial locations set the exposure to occur from an accidental release or from a deliberate terrorist attack. 2 Ammonia interacts immediately upon contact with available moisture in the skin, eyes, oral cavity, respiratory tract and particularly mucus surfaces to form the very caustic, ammonium hydroxide. Ammonium hydroxide causes necrosis of tissue through saponiication leading to cellular destruction. 2 he immediate efect of ammonia depends upon the route of exposure, whether it is inhalation, skin or eye contact or ingestion. Inhalation produces upper airway irritation with symptoms of lacrimation, cough, dyspnea, convulsion, coma and death. here is glolttic and laryngeal edema, sloughing of bronchial mucosa and chemical pneumonitis with pulmonary edema. Inhalation of the gas at concentration of above 5000 ppm can be rapidly fatal. Ocular exposure can result in lacrimation, conjunctivitis, corneal irritation and temporary or permanent blindness. 1 Exposure to high concentration of ammonia from swallowing results in corrosive damage to the mouth, throat and stomach. 2,3 So far the management of acute ammonia exposure is concerned, there is no antidote available for its poisoning, but ammonia’s efects can be treated and most people recover as per the previous literature. Immediate decontamination of skin and eyes with copious amount of water is important. Treatment consists of supportive Abstract Inhalational ammonia exposure may occasionally occur in industrial set up. Anhydrous ammonia is a colorless, pungent gas that may be stored or transported in pressurized liquid form. Here we present a case report on accidental ammonia inhalation, its clinical findings and management. A 55 year old male was exposed to inhalation of leaked ammonia gas from the pipeline of a fertilizer factory and came to the hospital after referral within 6 hour after exposure. The patient was presented with mild dyspnea, giddiness, gastrointestinal irritation, conjunctivitis and mucosal burning. The patient was managed aggressively with decontamination, fluid irrigation, IV fluid, steroid, bronchodilators, antibiotics, tear supplement and antibiotics eye drop. The patient was monitored for partial pressure of oxygen, oxygen saturation, pH, ECG, electrolytes, liver enzymes, renal function, CBC and chest X-ray. The patient was discharged in normal condition with follow up advice after 5 th day of admission. Immediate decontamination with maintenance of airway, breathing and circulation is crucial followed by monitoring is key for the management. Immediate conservative management of these patients led to good prognosis; otherwise it is usually fatal within first 4-6 hour of exposure. Keywords: Ammonia, inhalation, industry, clinical findings, management, prognosis. Received: 13-01-2016 Revised: 10-03-2016 Accepted: 14-04-2016 Ammonia Inhalation Toxicity: A Case Report Bibhuti Bhusana Panda 1* , Sarthak Ranjan Nayak 2 , Debasis Mishra 3 1 Department of Forensic Medicine & Toxicology, 2 Department of Biochemistry IMS & SUM Hospital, SOA University, 3 Apollo Hospital, Bhubaneswar Bhubaneswar, Odisha *bibhutifmt@gmail.com