Formic Acid Skin Burns Resulting in Systemic Toxicity, ,

Systemic toxicity developed in a 3-year-old girl burned by formic acid over 35% of her total body surface area. The patient presented with profound metabolic acidosis and a serum formate level of 400 μg/mL, the highest reported in the literature for poisoning by any route. The patient was successfully treated with hemodialysis, IV bicarbonate, and supportive measures. Reports of formic acid skin burns and systemic toxicity are limited. We discuss the pathophysiology and treatment of these cases.