kerosene is refined oil belonging to the hydrocarbon group of compounds , obtained from crude petroleum . poisoning is due to inhalation of fumes or ingestion of small amounts accidentally ( children ) or most of the cases reported in the literature were self - inflicted with the intention of committing suicide which constitutes significant emergency admissions . a 34-year - old male patient presented to our out - patient department with a history of injecting about 5 ml of kerosene to his left hand at two sites following an argument with his family members 2 days prior to presentation , with an intention to commit suicide . after 2 days , the pain became intolerable leading to disturbed sleep , with multiple blisters and swelling of the left hand . no other significant medical history was noted . on examination , he was an alert middle - aged man , moderately built and nourished , and well oriented to time , place , and person . multiple vesicles and blisters were present over the left forearm and few over the dorsal aspect of the left hand . black discoloration extending from the hand up to the lower third of the arm was present . local rise of temperature and tenderness was present from the hand up to lower third of arm . refilling could not be elicited [ figures 1 and 2 ] . multiple vesicles and blisters black discoloration extending from the hand up to the lower third of the arm was present . patient was unable to flex the hand few vesicles , blisters , and erosions were present over the dorsal aspect of the left hand there were no other lesions . irritant contact dermatitis the patient was admitted to the ward ; intravenous ( iv ) amoxycillin with clavulinic acid , iv steroid , and iv fluids were started . iv or subcutaneous self - injections of commercial gasoline or kerosene with suicidal intent constitute extraordinary events in psychotic patients . the lethal dose of kerosene for a 70 kg adult is 100 ml . in 1977 , green first described a patient who survived a 3 ml iv injection of energine , a derivate of kerosene . this patient developed lethargy , drowsiness , and a sterile abscess at the injection site without other systemic effects . our patient had injected 5 ml of kerosene and developed lesions over the forearm , as described . neeld and vaziri each reported a case of iv injection of petroleum distillate that caused severe chemical pneumonitis . in both cases , pulmonary edema and hypoxemia developed , and in one , the patient suffered abrupt respiratory arrest immediately after injection . kosa reported an accidental iv injection of 10 ml of gasoline that resulted in a fatal outcome . the case strongly suggested that hydrocarbons , as low - viscosity chemical compounds , have a direct toxic effect on lung tissue , interfering with gas exchange and leading to liquid interstitial pulmonary edema and severe hypoxemia caused by impaired diffusion . other effects of hydrocarbon intoxication include acute renal damage with oliguria , hepatocellular damage , intracellular hemolysis , gastric ulcers , and cardiac toxicity with negative inotropism . a case of self - inflicted acute necrotizing fasciitis with compromised venous return secondary to injection of kerosene was reported . a study on the clinical findings and outcome in suicide attempts by iv injection of kerosene among iv drug abusers was done in iran . although kerosene is a easily available refined oil as it is used for household purposes , poisoning occurs by inhaling fumes and ingestion accidentally in children and with the intention of committing suicide in adults . kerosene injection can produce severe tissue damage , especially if prompt surgical treatment is delayed . therefore , it is important to initiate active and immediate surgical intervention in the form of complete multiple fasciotomies , incision , and surgical excision of non - viable tissue . it should also be followed by active and repeated aggressive wound debridement until healthy granulation tissue is formed .