Lipid pneumonia can arise from two pathways: After topical application and/or repeated aspiration of lipids from food and other products containing lipids (exogenous lipid pneumonia), or due to the breakdown of fats into free fatty acids in the bronchial tree (endogenous lipid pneumonia) [1]. Based on the clinical presentation, lipid pneumonia may be further divided into acute and chronic [1] [2]. Acute exogenous lipid pneumonia is most frequently diagnosed in patients who aspirate a significant quantity of lipids (such as vaseline used for topical application or fat-rich mineral, animal or vegetable oils), the majority being elderly individuals in their sixth or seventh decades or children, many of whom have some pre-existing condition that predisposes them to aspiration [1] [3]. Dyspnea, cough, and low-grade fever are main symptoms that appear within the first hour after introduction of lipids into the lungs [1] [2], whereas chest pain, weight loss, and hemoptysis may be seen in more severe cases, when even respiratory failure and death may occur in the absence of adequate management and a delayed diagnosis [4] [5]. Aspiration of smaller contents of fat is mostly asymptomatic, which is typical for chronic forms of the disease, and the diagnosis is often made incidentally, but chronic persistent cough and dyspnea accompanied by weight loss may appear [1]. Endogenous lipid pneumonia has a similar clinical presentation, and it is associated with various conditions - Niemann-Pick disease, infections, non-small cell lung cancers, and pulmonary alveolar proteinosis (PAP) [1].

• Hypoxemia

  Laboratory investigations reveal hypoxemia, leukocytosis and raised erythrocyte sedimentation rate [1,2]. [indianpediatrics.net]

  Hypoxemia during lavage was slight, and a lower respiratory tract infection did not occur. However, we should note that this treatment may not be effective for patients with advanced cases of exogenous lipoid pneumonia. [rc.rcjournal.com]

  Hemoptysis is observed in 20% of the cases, and is not essential for establishing the diagnosis. 30 Hypoxemia is very typical and constitutes a key clue for suspecting the condition. 13,14 The chest X-ray findings tend to be suggestive of acute lung edema [medintensiva.org]

  Fan and Graham 13 reported a 4-month-old infant with respiratory distress and hypoxemia with a history of mineral oil administration at age 2 weeks who improved slowly. Mild residual abnormalities on CXR were present even at age 5 years. [pediatrics.aappublications.org]

• Fatigue

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 13, 2019 [patientslikeme.com]

  In Brief Section: A nonsmoking woman sought medical attention for nonproductive cough, dyspnea, low-grade fever, chills, and fatigue of 2 months duration. [atsjournals.org]

• Veterinarian

  Napier, {Julia E.}", year = "2010", month = "12", doi = "10.1638/2008-0046.1", language = "English (US)", volume = "41", pages = "710--712", journal = "Journal of Zoo and Wildlife Medicine", issn = "1042-7260", publisher = "American Association of Zoo Veterinarians [nebraska.pure.elsevier.com]

• Pneumonia

  Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal fat or vegetable or mineral oil. Endogenous lipoid pneumonia is usually associated with bronchial obstruction. [ncbi.nlm.nih.gov]

  Endogenous lipoid pneumonia, also called “cholesterol pneumonia” or “golden pneumonia,” is an obstructive pneumonitis. [dx.doi.org]

  Lipid pneumonia is a specific form of lung inflammation ( pneumonia ) that develops when lipids enter the bronchial tree. [en.wikipedia.org]

  […] tree (endogenous lipid pneumonia). [symptoma.com]

• Cough

  Aspiration of smaller contents of fat is mostly asymptomatic, which is typical for chronic forms of the disease, and the diagnosis is often made incidentally, but chronic persistent cough and dyspnea accompanied by weight loss may appear. [symptoma.com]

  He was fed by mouth and had occasional episodes of coughing and choking during feeding. He was asymptomatic at presentation and physical examination was unremarkable. [ncbi.nlm.nih.gov]

  Patient 2 was a diebetic who presented with a 4 month history of cough productive of white sputum and worsening shortness of breath. No history of other respiratory illness or any exposure history was obtained. [occupationalasthma.com]

• Tachypnea

  Physical examination findings included tachypnea and increased inspiratory sounds. Survey radiographs showed consolidation of both lung lobes, and a bronchoalveolar lavage sample contained cholesterol crystals. [nebraska.pure.elsevier.com]

  The case of a three and a half-year-old girl with spastic quadriplegic cerebral palsy, who was admitted to hospital for investigation of increasing tachypnea and respiratory distress over a two-month period, is presented. [ncbi.nlm.nih.gov]

• Chronic Cough

  Insights Section: • Chronic exogenous lipoid pneumonia can be symptomatic or can present with slowly progressive dyspnea and cough. [atsjournals.org]

  Symptomatic patients most frequently present with chronic cough or dyspnea. [dx.doi.org]

• Dry Cough

  In this study, both patients had mild symptoms of dry cough and dyspnea. [bmcpulmmed.biomedcentral.com]

  Immediately after the inhalation of a mouthful of an ignition fluid containing petroleum derivate (paraffin) he reported fever, dry cough, haemoptysis, and intense chest pain exacerbated by the acts of breathing and the coughing. [omicsonline.org]

  An established risk factor is the presence of chronic GVHD, in view of the inflammation and progressive fibrosis of the lung tissues that appear in graft disease. 2,9,13,30,35 Fever associated to dry cough and tachypnea, with interstitial infiltrates [medintensiva.org]

Because symptoms of lipid pneumonia are non-specific and may mimic various other respiratory diseases (infections, malignancies, autoimmune disorders, etc.), a thorough diagnostic workup is mandatory, as lipid pneumonia is often diagnosed after a significant delay in many patients [6]. Having in mind the fact that auscultation of the lungs may frequently reveal no pathological findings (although wheezing or crepitations can be noted in severe cases), a detailed patient history is perhaps the most important part of the assessment of respiratory symptoms. Recent or chronic use of topical fat-containing creams or drugs or the appearance of symptoms after consumption of fat-rich foods, especially in elderly and children, is a valuable information. Imaging studies, however, are vital in order to distinguish fat accumulation from tumors or focal infections, and plain radiography, but more commonly, computed tomography (CT) are widely recommended early on [2] [3] [4] [6]. Pulmonary opacities are seen after 24 hours in virtually all patients who develop acute symptoms, and their appearance depends on the extent of aspirated or accumulated fat. In most cases, ground-glass or consolidative opacities that are distributed segmentally or within a pulmonary lobe, usually in the middle or lower segments, are typical for lipid pneumonia, whereas pneumatoceles, pneumothorax, pleural effusions and pneumomediastinum may also be encountered, indicating a poorer prognosis [1] [3]. CT of the chest can distinguish lipid structures due to their low attenuation and thickening of the intralobular septa, known as "crazy paving pattern" [2]. Magnetic resonance imaging (MRI) is sometimes employed when CT and radiography yield inconclusive findings, but the use of bronchoalveolar lavage (BAL) or bronchoscopy as a tool to obtain a viable sample for biopsy was necessary for a significant number of patients, and histopathological confirmation of lipid droplets in alveoli and local macrophages serves as a definite method [1] [4] [6].

• Pulmonary Infiltrate

  Case report We report a case of a 38-year-old woman with bilateral pulmonary infiltration. There were no clinical symptoms of this infiltration at diagnosis. [elsevier.pt]

  Chest radiograph [Figure 1] demonstrated bilateral pulmonary infiltrates, more on the left lower zone and computed tomography (CT) of the thorax [Figure 2] showed multifocal areas of low attenuation consolidation predominantly in the left lower lobe. [lungindia.com]

  Deposition of mineral oil in the lung may be associated with an asymptomatic, incidentally discovered pulmonary infiltrate ( 4 ), or may lead to severe lung disease and death ( 5 ). [ncbi.nlm.nih.gov]

• Bilateral Pulmonary Infiltrates

  Case report We report a case of a 38-year-old woman with bilateral pulmonary infiltration. There were no clinical symptoms of this infiltration at diagnosis. [elsevier.pt]

  Chest radiograph [Figure 1] demonstrated bilateral pulmonary infiltrates, more on the left lower zone and computed tomography (CT) of the thorax [Figure 2] showed multifocal areas of low attenuation consolidation predominantly in the left lower lobe. [lungindia.com]

• Ground Glass Appearance

  Fig. 1 Contrast enhanced CT of chest (axial section in lung window) showing ground glass appearance, air trapping and consolidation. She received oral prednisolone and azathioprine (2 mg/kg/day) for 9 months. [indianpediatrics.net]

Margaret W.Leigh consulted on the treatment plan, critically reviewed the manuscript and contributed to the discussion. Terry L. Noah developed the treatment plan and critically reviewed the manuscript. [doi.org]

Treatment These are the most common treatments recommended for lipoid pneumonia: Corticosteroids Immunoglobulins – intravenous administration. For the symptoms of the exogenous lipoid pneumonia to improve, no treatment is necessary. [heydoctor.org]

Treatment of lipoid pneumonia is not well studied, and the published literature contains only case reports. [rc.rcjournal.com]

Fibrosis is reported as an end result in lipoid pneumonia but azathioprine use for the treatment has not been earlier reported [1,2]. [indianpediatrics.net]

If treatment is needed, therapeutic bronchoalveolar lavage may remove substantial quantities of lipid from the alveoli; episodes of secondary bacterial infection require antibiotic treatment.... [oxfordmedicine.com]

The prognosis in this entity is usually good and complications are rare. We report an unusual case of chronic lipid pneumonia complicated with massive haemoptysis who responded to steroid therapy after arterial embolization. [ncbi.nlm.nih.gov]

Prognosis It is possible that the endogenous lipoid pneumonia appears prior to other medical conditions, such as the pulmonary alveolar proteinosis. [heydoctor.org]

[…] are distributed segmentally or within a pulmonary lobe, usually in the middle or lower segments, are typical for lipid pneumonia, whereas pneumatoceles, pneumothorax, pleural effusions and pneumomediastinum may also be encountered, indicating a poorer prognosis [symptoma.com]

Signal characteristics may reflect fat/paraffin content. usually: T1: high to intermediate signal 7 T2: low to intermediate signal 7 Treatment and prognosis Serial radiographs showing stability may be enough in asymptomatic patients with no background [radiopaedia.org]

Prognosis [ edit ] Endogenous lipoid pneumonia and non-specific interstitial pneumonitis has been seen prior to the development of pulmonary alveolar proteinosis in a child. [5] History [ edit ] Laughlen first described lipid pneumonia in 1925 with infants [en.wikipedia.org]

The etiology of PAP includes genetic, primary (anti-granulocyte-macrophage colony-stimulating factor antibodies) and secondary (oncologic, rheumatologic, infectious, chemical and immunologic) causes. [ncbi.nlm.nih.gov]

The etiology of PAP includes genetic, primary (anti‐granulocyte‐macrophage colony‐stimulating factor antibodies) and secondary (oncologic, rheumatologic, infectious, chemical and immunologic) causes. [doi.org]

Idiopathic interstitial pneumonias(IIPs) are progressive interstitial lung diseases of unknown etiology with a variety of inflammatory and fibrotic changes. [medphas.kumamoto-u.ac.jp]

Mycobacterium fortuitum Mycobactériose Pneumonie interstitielle cholestérol Surinfection Tomodensitométrie Toxicité Balsamorhinol Actinomycetes Bactérie Bactériose Infection Mycobacteriaceae Mycobacteriales Keyword (en) Respiratory disease Complication Etiology [pascal-francis.inist.fr]

However, the clear right predominance of lesions gave primary support to the aspiration etiology of lesions. Laboratory blood findings (hematology, biochemistry, antibody, tumor markers) were normal. [elsevier.pt]

The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and [doi.org]

The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the [ingentaconnect.com]

Pathophysiology Lipid pneumonia leads to the appearance of a pale-yellow area on the surface of the lungs. Because of this characteristic appearance, this condition is sometimes presented as “golden pneumonia”. [heydoctor.org]

[…] children with a view to regularize bowel habits. [5] One of the common practices in developing countries is siphoning out mineral oil from automobiles as in our patient; however, hydrocarbon pneumonitis in this setting has been rarely reported. [6] The pathophysiology [lungindia.com]

(November 6, 2017) Centers for Disease Control and Prevention. CDC Features: Pneumonia can be prevented—vaccines can help. Available online at https://www.cdc.gov/Features/Pneumonia/. Accessed on September 8, 2018. [labtestsonline.it]

Optimization of oral hygiene and regular care by a dentist may help prevent development of pneumonia or abscess in patients who repeatedly aspirate. [merckmanuals.com]

"Lipoid pneumonia: An unusual and preventable illness in elderly patients". Canadian Family Physician. 61 (9): 775–777. PMC 4569110. PMID 26371101. ^ "Pulmonary Pathology". [en.wikipedia.org]

"Lipoid pneumonia: An unusual and preventable illness in elderly patients". Canadian Family Physician. 61 (9): 775–777. PMC 4569110. PMID 26371101. ↑ "Pulmonary Pathology". [ipfs.io]

Any products described are not intended to diagnose, treat, cure, or prevent any disease. Website Disclosure: This forum contains general information about diet, health and nutrition. [forum.grasscity.com]

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6. Hadda V, Khilnani GC. Lipoid pneumonia: an overview. Expert Rev Respir Med. 2010 Dec;4(6):799-807.