Fire eater's pneumonia characterized by pneumatocele formation and spontaneous resolution

Kadakal, Figen; Uysal, Mehmet Atilla; Gulhan, Nazan Bayram; Turan, Nurten Guner; Bayramoğlu, Sibel; Yılmaz, Veysel T.

doi:10.4261/1305-3825.dir.1591-07.1

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…Therefore, this condition was called a fire-eater’s lung. Cases of fire-eater’s lung described in the literature [2,12–18] are similar to the one presented in this article. Patients report to hospital due to cough, dyspnea, chest pain, hemoptysis and fever.…”

Section: Discussionsupporting

confidence: 77%

Egzogenne tłuszczowe zapalenie płuc u połykacza ognia-opis przypadku

et al. 2012

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SummaryBackground:Exogenous lipoid pneumonia is an uncommon condition caused by inhalation or aspiration of a fatty substance. It usually presents as chronic respiratory illness mimicking interstitial lung diseases. Acute exogenous lipoid pneumonia is uncommon and typically is caused by an episode of aspiration of a large quantity of a petroleum-based product. Radiological findings vary and may imitate many other diseases.Case Report:We present a rare case of acute exogenous lipoid pneumonia in a fire-eater who aspirated liquid paraffin during his flame-blowing show (fire-eater’s lung). He was admitted to the hospital with productive cough, fever, hemoptysis, chest pain and dyspnea. Diagnosis was made on the basis of history of exposure to fatty substance, characteristic findings in CT examination and presence of lipid-laden macrophages in bronchoalveolar lavage fluid.Conclusions:Acute exogenous lipoid pneumonia is a very rare disease that typically occurs in fire-eaters and is called a fire-eater’s lung. The diagnosis is made on the basis of typical history and radiological, as well as histopathological findings.

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Section: Discussionsupporting

confidence: 77%

Egzogenne tłuszczowe zapalenie płuc u połykacza ognia-opis przypadku

et al. 2012

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“…The most often seen lung lesions on CT scans of fire-eaters are pneumotoceles (well-defined cavitary lesions) within consolidative or ground-glass opacities [1,2,6,15]. The other lung lesions like pleural effusion, pneumothorax, pneumomediatinum and broncho-pleural fistula are sparsly observed [1,2,3,14].…”

Section: Discussionmentioning

confidence: 99%

“…Liquid hydrocarbons (LHs) are widely present in our environment, households and in industry [6]. The most frequently used products of petroleum are as follows: gasoline, motor oils, lubricating oils, diesel oil, kerosene, lighter fluid, and lamp oil [3,4,6]. …”

Section: Introductionmentioning

confidence: 99%

Fire-Eater’s Lung

Załeska¹,

Błaszczyk

Jakubowska

et al. 2016

Advances in Respiratory Medicine

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Fire eater's lung (FEL) is an acute hydrocarbon pneumonitis caused by aspiration or inhalation into airways of liquid hydrocarbons. This disorder is classified into distinct form of chemical toxic pneumonitis. An amateur fire-eater is presented in this work. He accidentally aspirated into airways about 1/3 of glass of grill lighter fluid composed of mixture of liquid hydrocarbons. A few hours after this incident he had severe symptoms like weakness, high temperature, midsternal pleuritic chest pain, myalgia of the back, shortness of breath, and dry cough. Radiologic examination revealed consolidations with well−defined cavitary lesions (pneumatoceles) in lower lobes mainly in the left lower lobe. After one week of this event clinical improvement was observed. The lesions resolved nearly completly during three months. The review of the literature connected with fire-eater's lung is also presented.

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“…As most cases resolve spontaneously, treatment with prophylactic antibiotics and corticosteroids is controversial. Unless complicated, it was proposed to treat the patients only symptomatically (1)(2)(3)(4). In our case, the patient received antibiotics because of high fever and leukocytosis, but no steroids were needed as there was a quick fever response and no sign of respiratory insufficiency.…”

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confidence: 91%

Fire-eater’s pneumonia

Taş

Durum²,

Karaman³

2015

Diagn Interv Radiol

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We read with interest the case report entitled "Fire-eater's pneumonia characterized by pneumatocele formation and spontaneous resolution" by Kadakal et al. (1) published in Diagnostic and Interventional Radiology. The article gave us the inspiration to share a nearly identical case of fire-eater's pneumonia with somewhat different features on computed tomography (CT) and a very typical history. The disease is a rare form of chemical toxic pneumonitis, developing after aspiration of hydrocarbon products (1-3). Due to their chemical properties, these products easily spread through the airways by reducing the effectiveness of cough and choke reflexes, and give damage to bronchial mucosa and lung tissue due to high absorp tion rate (3). The resultant pathology is necrotizing acute bronchiolitis and necrotizing acute fibrinous pneumonia. Dyspnea, cough, hemoptysis, chest pain, and fever are the symptoms. Clinical characteristics of the patients, the disease, and the outcome can be variable (1). A 30-year-old male patient, an actor performing fire breathing shows for the past several years, was admitted acutely to emergency room with complaints of high fever, weakness, cough, and dyspnea. Physical examination and his general body habitus was within normal limits. On admission, the patient remained in a relatively good condition, without signs of respiratory failure. Laboratory studies showed leukocytosis (27.17×10 3 /µL) with a left shift and significantly elevated CRP (169 mg/L) and procalcitonin (1.17 ng/mL). Initial chest radiograph showed smoothly bordered mass-like opacities (consolidations) on both lower paracardiac areas (Fig. 1). Computed tomography revealed almost symmetric consolidations with no air bronchograms on both lower and right middle lobes with some nearby nodules. The consolidations contained low attenuating cyst-like areas, and were also surrounded by ground glass infiltrations on thin-section images (Fig. 2). Patient was hospitalized with the diagnosis of chemical pneumonitis and received empirical antibiotic treatment ampicillin-sulbactam (6.0 g/day), bronchodilators, and oxygen. Fever response was achieved on the fifth day. Leukocyte count, CRP, and procalcitonin levels approached to normal on the tenth day, and clinical improvement was seen. Unfortunately the patient discharged himself against medical advice, hindering further follow-up examinations. In fire-eater's pneumonia the diagnosis is based on history and radiological findings (2). Chest radiographs may show areas of consolidation, well-circumscribed nodules, pneumatocele, atelectasis, and pleural effusion, or even potential complications like pneumothorax (1). In a series of 44 exogenous lipid pneumonia cases of more familiar causatives like liquid paraffin, the afore mentioned findings were

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Fire eater's pneumonia characterized by pneumatocele formation and spontaneous resolution

Cited by 9 publications

References 10 publications

Egzogenne tłuszczowe zapalenie płuc u połykacza ognia-opis przypadku

Egzogenne tłuszczowe zapalenie płuc u połykacza ognia-opis przypadku

Fire-Eater’s Lung

Fire-eater’s pneumonia

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