[Lipoid pneumonia - an underestimated syndrome]

Lipoid Pneumonia Secondary to Diesel Aspiration: An Occupational Hazard

Lipoid pneumonia is defined as a type of pneumonia that occurs as a result of inhalation of either endogenous or exogenous lipid-containing products in the lungs. We present the case of a 55-year-old male patient who presented with chief complaints of cough with blood-tinged sputum, right-sided chest pain, dyspnea, and fever for two days. The patient gave a history of working as a mechanic in an automobile garage and reported an episode of accidental aspiration of diesel during diesel siphoning at the workplace. A chest X-ray and computed tomography (CT) scan of the chest were done, which revealed right-sided lower lobe consolidation. The patient was admitted and started on intravenous antibiotics, corticosteroids, and inhaled bronchodilators, along with oxygen support. A bronchoscopy was done, which revealed the presence of thick mucoid secretions in the right lower lobe bronchus. The patient was discharged after 10 days with stable vitals and was advised to have regular follow-ups to monitor for any long-term pulmonary complications.

Report of a Rare Case of Computed Tomography Diagnosis of Hydrocarbon Pneumonitis

The practice of manually siphoning diesel from fuel tanks is widespread among car mechanics in Asian countries. To date, there are just a few reports in the literature about hydrocarbon pneumonitis caused by diesel fuel aspiration. An early diagnosis based on clinical suspicion, imaging results, and histopathology can help prevent permanent damage to the lungs.

[Cough and Exertional Dyspnoea after Oily Mentholine Inhalation]

A 48-year-old-male presented with a five-week history of non-productive cough and exertional dyspnoea. A pulmonary function test showed a mild diffusion disorder. A CT scan revealed an atypical pneumonia with bipulmonary consolidations, which were accentuated in the right upper lobe. The transbronchial biopsy showed lipid-loaded macrophages. These findings confirmed the diagnosis of a lipoid pneumonia, which developed in the context of inhalation of substances containing menthol. After discontinuation of the causative agent and high-dose steroid administration the symptoms were reversible within a few weeks.

Diesel siphoner's lung: An unusual cause of hydrocarbon pneumonitis

The practice of manual siphoning of diesel from fuel tanks is common among automobile mechanics in Nepal. When an automobile mechanic with a history of diesel siphonage presents with respiratory symptoms, the diesel siphoner's lung diagnosis should be considered. Clinical suspicion confirmed by radiological findings can help in early management and prevention of permanent damage.

A rare case of lipoid pneumonia attributed to amiodarone

We report a case of endogenous lipoid pneumonia secondary to long-term use of amiodarone (> 30 years) for atrial fibrillation in a 76-year-old Caucasian woman, presenting with cough and dyspnea. Endogenous Lipoid pneumonia is a rare underdiagnosed condition more prevalent in adults. It is usually asymptomatic and a diagnosis is generally made in patients who have become clinically unstable or when an abnormal lung shadow is found on a chest X-ray. In the case here described it was diagnosed by fiberoptic bronchoscopy with bronchoalveolar lavage (BALF) where fat-laden macrophages (oil red O stain) were identified. Since a history of use of oil-based products had been ruled out, amiodarone was deemed to be the most likely cause of lipoid pneumonia. The patient was managed with the replacement of amiodarone with digoxin and treated with oral prednisolone. The patient has remained clinically stable with radiological improvement during a follow-up of two years.