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Allergy Asthma Respir Dis. 2019 Jan;7(1):57-60. Korean.
Published online Jan 30, 2019.  https://doi.org/10.4168/aard.2019.7.1.57
© 2019 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
Exogenous lipoid pneumonia presented by acute eosinophilic pneumonia
Gil Myeong Seong and Miok Kim
Departments of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

Correspondence to: Miok Kim. Departments of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Korea. Tel: +82-64-717-1614, Fax: +82-64-717-1131, Email: miohkim@hanmail.net
Received Dec 16, 2017; Revised Jan 12, 2018; Accepted Jan 19, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).


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.

Keywords: Lipid pneumonia; Pulmonary eosinophilia; Respiratory aspiration

Figures


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).
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Notes

This work was supported by the research grant of Jeju National University in 2015.

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