Acute exogenous lipoid pneumonia caused by accidental kerosene ingestion in an elderly patient with dementia: A case report

Abstract

Acute exogenous lipoid pneumonia is an uncommon condition caused by aspiration of oil-based substances, occurring mainly in children. Here, we report the case of an 83-year-old patient with Alzheimer's disease who presented with coughing and hypoxia. The diagnosis of acute exogenous lipoid pneumonia caused by accidental kerosene ingestion was made on the basis of the patient's clinical history, and typical radiological and cytological findings. The patient's cognitive impairment and an unsafe environment, in which the patient's 91-year-old husband stored kerosene in an old shochu bottle, were responsible for the accidental ingestion. Acute exogenous lipoid pneumonia should be considered in the differential diagnosis for acute respiratory disorders in the rapidly aging population.

Effects and mechanisms of kerosene use-related toxicity

“…There are therefore high chances that the dangers that kerosene exposures pose to mothers may extend to A c c e p t e d M a n u s c r i p t the unborn foetus during pregnancy. It is noteworthy that most poisoning cases in children from accidental kerosene ingestion have reported survival following ingestion of up to 1.7 gkg -1 with fatalities having been associated with doses ranging from 2 to 17 gkg -1 [7,14,15]. However, these fatalities or severe cases were majorly associated with aspiration of vomitus (chemical pneumonitis) rather than systemic kerosene toxicity per se.…”

Exogenous Lipoid Pneumonia as a Contributory Factor in a Drug‐related Death

“… concluded that it was not always successful and should not be proposed systematically. Supportive measures, such as oxygen, respiratory therapy, control of risk factors, and whole‐lung lavage should be considered, or even antibiotics if a secondary infection complicates the LP , but no consensus exists.…”

“…Weight loss, hemoptysis, chest pain, and fever are less commonly reported (2,5,6,10,11). In the literature, the acute form mostly concerns accidental poisoning in children, suicide attempts, and especially fire-eating (12)(13)(14)(15). Moreover, Weinberg et al (16) and Seaton (17) distinguished fire-eaters from fire breathers.…”

Unusual case of accidental kerosene ingestion by an adult

“…5 Kerosene stored in water bottle or glass in the kitchen can easily be mistaken as water in the dark. In our case, kerosene was kept in a stainless steel tumbler and the patient forgot to remove the remaining kerosene after cooking was over.…”