Allergy Asthma Respir Dis.  2019 Jan;7(1):57-60. 10.4168/aard.2019.7.1.57.

Exogenous lipoid pneumonia presented by acute eosinophilic pneumonia

• Seong GM
• Kim M

• KMID: 2434131
• DOI: http://doi.org/10.4168/aard.2019.7.1.57

Abstract

Exogenous lipoid pneumonia is an uncommon medical condition resulting from aspiration or inhalation of oily material. Generally, lipoid pneumonia has nonspecific clinical and radiological presentations, and may be misdiagnosed as bacterial pneumonia or lung cancer. We describe an unusual case of exogenous lipoid pneumonia accompanied by peripheral blood and pulmonary eosinophilia. A 63-year-old man was admitted with progressively worsening exertional dyspnea and productive cough for 5 days. A chest radiograph showed abnormalities in the lower lobe of the right lung, and a diagnosis of community-acquired pneumonia was made; intravenous antibiotics were administered. However, dyspnea and hypoxia gradually worsened and peripheral blood eosinophilia developed. A bronchoscopy was performed and bronchoalveolar lavage fluid analysis showed markedly increased numbers of eosinophils (40%). Subsequently, a comprehensive review of history revealed that he fell asleep with camellia oil in his mouth for 2 weeks to relieve foreign body sensation of the throat. Sputum and bronchoalveolar lavage fluid cytology showed the presence of lipid-laden macrophages. He was diagnosed with lipoid pneumonia and acute eosinophilic pneumonia. Chest radiograph and symptom were rapidly improved after treatment with intravenous methylprednisolone.

Keyword

Lipid pneumonia; Pulmonary eosinophilia; Respiratory aspiration

MeSH Terms

Anoxia
Anti-Bacterial Agents
Bronchoalveolar Lavage Fluid
Bronchoscopy
Camellia
Cough
Diagnosis
Dyspnea
Eosinophilia
Eosinophils*
Foreign Bodies
Humans
Inhalation
Lung
Lung Neoplasms
Macrophages
Methylprednisolone
Middle Aged
Mouth
Pharynx
Pneumonia*
Pneumonia, Bacterial
Pneumonia, Lipid
Pulmonary Eosinophilia*
Radiography, Thoracic
Respiratory Aspiration
Sensation
Sputum
Anti-Bacterial Agents
Methylprednisolone

Figure

• 

  Fig. 1. Chest X-ray of the patient showing patchy consolidation in both middle and lower lung fields (A), and almost complete resolution after 1 month (B).

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  Fig. 2. Chest computed tomography scan reveals diffuse patchy peribronchial consolidation and ground-glass opacities in both lungs (A, B), predominantly in the right lower lung (B).

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  Fig. 3. Sputum cytology shows lipid-laden macrophages (Oil red O stain, ×400).

Reference

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