Lipoid Pneumonia in a Gas Station Attendant

Abstract

The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to presenting with a respiratory infection that was hard to resolve. The patient underwent bronchoscopy with bronchoalveolar lavage, which, on cytochemical (oil red O) evaluation, was slightly positive for lipid material in the foamy cytoplasm of alveolar macrophages. Due to his occupational history and radiographic abnormalities suggestive of lipoid pneumonia, a lung biopsy was performed to confirm the diagnosis. The patient was serially treated with segmental lung lavage and showed clinical, functional, and radiological improvement.

Teppanyaki/Hibachi Pneumonitis: An Exotic Cause of Exogenous Lipoid Pneumonia

“…However, false-negative results may occur, and the finding is nonspecific [19]. Slight increase in eosinophil numbers may increase the specificity of BAL in diagnosing ELP [14, 20] which was also seen in our patient, despite the absence of other characteristic BAL findings.…”

“…The mechanism of injury is thought to occur after flame blowing, when the fire-eater takes a deep inspiration, and Kerdan remaining in the mouth can be aspirated [7–10]. Diesel siphoner's lung is a hydrocarbon pneumonitis described in individuals who transfer or steal gasoline from vehicles using a tube or a hose, where the individual draws the fluid with negative inspiratory force, often aspirating small quantities into the airway and lungs, “perhaps exacerbated by the rush of the moment!”, triggering a similar inflammatory pulmonary reaction caused by petroleum hydrocarbons [11–14]. …”

Occupational Exogenous Lipoid Pneumonia: A Commonly Delayed Diagnosis

“…Lipoid pneumonia is more frequent in children and the elderly, often due to an excessive use of mineral oil for the treatment of constipation. In such instances, the presentation may be in the acute form (2). This disease can also be caused by exposure to oily substances in the work area.…”

“…Our patient demonstrated improvement following avoidance of multipurpose grease. Systemic corticosteroids have been shown to be effective in some cases (2,4). Total pulmonary lavage has also been reported to be useful in the cortico-resistant form (6).…”

“…Anahtar Sözcükler: Lipoid pnömoni, mesleki maruziyet, yağlayıcı madde. pneumonia and pulmonary tuberculosis (2). As a result, diagnosis can be delayed and symptoms can persist for a long period.…”