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Polymer Fume Fever

Mold Machine Pneumonia

Polymer fume fever is a rare disease that arises due to inhalation of polytetrafluoroethylene (PTFE) or Teflon(®) that is degraded during heating processes such as cooking or in the occupational setting. Signs and symptoms start several hours after exposure, most common being a flu-like illness with fever, chills, a sore throat, weakness, and dyspnea in severe cases. Spontaneous resolution within a few days is observed in the majority of cases. Data obtained during history taking is crucial to make the diagnosis.


Presentation

Polymer fume fever is now considered to be a rare occurrence in clinical practice and was initially described as an occupational disease [1] [2] [3]. The pathogenesis involves inhalation of degraded polytetrafluoroethylene or Teflon(®), either during various industrial heating processes (> 350°C) or during household cooking using Teflon-lined pans that release fumes containing this fluorocarbon [1] [4] [5]. The exact reason why signs and symptoms appear after inhalation of these fumes remains unclear, but it is assumed that a pro-inflammatory reaction in the lungs with subsequent formation of reactive oxygen species is the main mechanism [6]. The clinical presentation usually starts several hours after inhalation of polytetrafluoroethylene and most reports suggest that a "flu-like" illness comprised of a dry cough, fever, chills, a sore throat, and even dyspnea is the main presenting feature [1] [3] [4] [7] [8]. Joint pain may also be reported [2]. Spontaneous resolution of symptoms is noted within a few days and their complete absence during the weekend is observed in the setting of occupational exposure [2] [6]. In rare cases, however, polymer fume fever can lead to severe pulmonary changes such as edema, consolidation, and pneumonitis, whereas fatalities from polymer fume fever, although very rare, have also been documented [1] [4] [8]. Cigarette smoking is one of the most important risk factors, which led to severe smoking prohibitions in industrial areas where polytetrafluoroethylene is released in fumes [1] [2].

Fever
  • In rare cases, however, polymer fume fever can lead to severe pulmonary changes such as edema, consolidation, and pneumonitis, whereas fatalities from polymer fume fever, although very rare, have also been documented.[symptoma.com]
  • Inhalation of fluoropolymer pyrolysis products causes a self-limited illness termed polymer fume fever; symptoms include fever, chills, myalgias and non-productive cough, and are easily mistaken for an acute viral illness.[ncbi.nlm.nih.gov]
  • From Wikidata Jump to navigation Jump to search No description defined fluoropolymer fever Teflon flu edit Language Label Description Also known as English polymer fume fever No description defined fluoropolymer fever Teflon flu Statements subclass of[wikidata.org]
  • Based on the patient history, images and the pan he brought to the hospital, polymer fume fever was strongly suspected. His symptoms dramatically improved over the following 2 days after admission.[ncbi.nlm.nih.gov]
Chills
  • Signs and symptoms start several hours after exposure, most common being a flu-like illness with fever, chills, a sore throat, weakness, and dyspnea in severe cases. Spontaneous resolution within a few days is observed in the majority of cases.[symptoma.com]
  • Inhalation of fluoropolymer pyrolysis products causes a self-limited illness termed polymer fume fever; symptoms include fever, chills, myalgias and non-productive cough, and are easily mistaken for an acute viral illness.[ncbi.nlm.nih.gov]
  • Symptoms are flu-like (chills, headaches and fevers) with chest tightness and mild cough. Onset occurs about 4 to 8 hours after exposure to the pyrolysis products of PTFE.[en.wikipedia.org]
  • Victims of polymer fume fever will often experience: Chills Headaches Fever Chest tightness Mild cough Onset occurs about four to eight hours after exposure.[corrosionpedia.com]
  • All of those involved demonstrated the classic history of an influenza-like syndrome, with fever and chills occuring several hours after exposure to the products of pyrolysis of polytetrafluoroethylene (Teflon).[jamanetwork.com]
Malaise
  • […] is usually absent FOB : marked influx of neutrophils Clinical (onset of symptoms 4-8 hrs after acute inhalation of fumes or dust) Mild Dyspnea (see Dyspnea , [[Dyspnea]]) Cough (see Cough , [[Cough]]) Fever (see Fever , [[Fever]]) Flu-Like Syndrome Malaise[mdnxs.com]
  • CLINICAL PRESENTATION: Metal fume fever typically presents with generally non-specific complaints including influenza-like symptoms, fever, shaking chills, arthalgias, myalgias, headache, and malaise.[ncbi.nlm.nih.gov]
  • He had a lower backache followed, after 30 to 45 minutes, by intense rigors, nocturnal fever, chills, malaise, and a more intense backache. He also experienced a dry, nonproductive cough. By morning, he felt much better.[cdc.gov]
  • […] cases were identified in a retrospective study looking at the preceding 5.5 years: 99% cases in adults 96% cases in men rapid onset of symptoms (5-10 hours) following exposure to the fumes flu-like symptoms fever, rigors, arthralgia, myalgia, headache, malaise[radiopaedia.org]
Fatigue
  • Several hours after that, he gradually felt fatigue and dyspnoeic. He became anxious and called emergency medical service. He denied chest pain, nausea, vomiting or diarrhoea. He was not on any medication and was not allergic to any drug or food.[ncbi.nlm.nih.gov]
Constitutional Symptom
  • Clinical manifestations are typically characterised by constitutional symptoms such as fever, shivering, sore throat and weakness.[ncbi.nlm.nih.gov]
Cough
  • A 29-year-old Japanese man presented with fever, dyspnoea and non-productive cough after massive inhalation of evaporant from a polytetrafluoroethylene-coated cooking pan. Chest CT scan showed diffuse interstitial infiltration in both lungs.[ncbi.nlm.nih.gov]
  • Inhalation of fluoropolymer pyrolysis products causes a self-limited illness termed polymer fume fever; symptoms include fever, chills, myalgias and non-productive cough, and are easily mistaken for an acute viral illness.[ncbi.nlm.nih.gov]
  • A previously healthy 21-year-old white man presented with severe chest tightness, difficulty in breathing, pyrexia, nausea, vomiting, and a dry irritating cough.[ncbi.nlm.nih.gov]
  • (see Cough , [[Cough]]) Fever (see Fever , [[Fever]]) Flu-Like Syndrome Malaise Chills Myalgia Treatment Self-Limited : usually spontaneously resolves within 12-48 hrs References xxx[mdnxs.com]
Dry Cough
  • The clinical presentation usually starts several hours after inhalation of polytetrafluoroethylene and most reports suggest that a "flu-like" illness comprised of a dry cough, fever, chills, a sore throat, and even dyspnea is the main presenting feature[symptoma.com]
  • Breathlessness during exercise is one of the initial symptoms of these diseases, while a dry cough may also be present. People with different types of ILD may have the same kind of symptoms but their symptoms may vary in severity.[books.google.com]
  • [Journal Article] TN Tidsskr Nor Laegeforen 1998 Mar 20; 118(8):1223-4 Ellingsen CL Polymer fume fever is a self-limiting condition with influenza-like symptoms (fever, headache, dry cough, dyspnoea and myalgia).[unboundmedicine.com]
  • Manifestations of polymer-fume fever comprise chest tightness, a choking sensation, dry cough, fever, chills, and pains in the joints. Symptoms begin several hours after exposure and resolve within a day or two (4,5).[cdc.gov]
  • DISEASE NAME DESCRIPTION Metal fume fever Symptoms: flu-like illness with a metallic taste in the mouth, throat irritation, and dry cough; Signs: leucocytosis (high white blood cell count) is common; normal chest x-ray; Onset after exposure: 3-10 hours[haz-map.com]
Dry Cough
  • The clinical presentation usually starts several hours after inhalation of polytetrafluoroethylene and most reports suggest that a "flu-like" illness comprised of a dry cough, fever, chills, a sore throat, and even dyspnea is the main presenting feature[symptoma.com]
  • Breathlessness during exercise is one of the initial symptoms of these diseases, while a dry cough may also be present. People with different types of ILD may have the same kind of symptoms but their symptoms may vary in severity.[books.google.com]
  • [Journal Article] TN Tidsskr Nor Laegeforen 1998 Mar 20; 118(8):1223-4 Ellingsen CL Polymer fume fever is a self-limiting condition with influenza-like symptoms (fever, headache, dry cough, dyspnoea and myalgia).[unboundmedicine.com]
  • Manifestations of polymer-fume fever comprise chest tightness, a choking sensation, dry cough, fever, chills, and pains in the joints. Symptoms begin several hours after exposure and resolve within a day or two (4,5).[cdc.gov]
  • DISEASE NAME DESCRIPTION Metal fume fever Symptoms: flu-like illness with a metallic taste in the mouth, throat irritation, and dry cough; Signs: leucocytosis (high white blood cell count) is common; normal chest x-ray; Onset after exposure: 3-10 hours[haz-map.com]
Dyspnea
  • Signs and symptoms start several hours after exposure, most common being a flu-like illness with fever, chills, a sore throat, weakness, and dyspnea in severe cases. Spontaneous resolution within a few days is observed in the majority of cases.[symptoma.com]
  • (see Dyspnea , [[Dyspnea]]) Cough (see Cough , [[Cough]]) Fever (see Fever , [[Fever]]) Flu-Like Syndrome Malaise Chills Myalgia Treatment Self-Limited : usually spontaneously resolves within 12-48 hrs References xxx[mdnxs.com]
  • }, year {2006}, volume {19 3}, pages { 279-82 } } Masami Son , Eiichi Maruyama , 3 authors Masahiro Ogawa Published in Chudoku kenkyu : Chudoku Kenkyukai jun kikanshi… 2006 A 30-year old man was admitted to our hospital with cough, slight fever, and dyspnea[semanticscholar.org]
Chest Pain
  • He denied chest pain, nausea, vomiting or diarrhoea. He was not on any medication and was not allergic to any drug or food. He brought the cooking pan with him, and the coating of the centre of the pan was burnt ( figure 1 ).[ncbi.nlm.nih.gov]
Headache
  • Symptoms are flu-like (chills, headaches and fevers) with chest tightness and mild cough. Onset occurs about 4 to 8 hours after exposure to the pyrolysis products of PTFE.[en.wikipedia.org]
  • Victims of polymer fume fever will often experience: Chills Headaches Fever Chest tightness Mild cough Onset occurs about four to eight hours after exposure.[corrosionpedia.com]
  • [Journal Article] TN Tidsskr Nor Laegeforen 1998 Mar 20; 118(8):1223-4 Ellingsen CL Polymer fume fever is a self-limiting condition with influenza-like symptoms (fever, headache, dry cough, dyspnoea and myalgia).[unboundmedicine.com]
  • CLINICAL PRESENTATION: Metal fume fever typically presents with generally non-specific complaints including influenza-like symptoms, fever, shaking chills, arthalgias, myalgias, headache, and malaise.[ncbi.nlm.nih.gov]
  • Australia, 85 cases were identified in a retrospective study looking at the preceding 5.5 years: 99% cases in adults 96% cases in men rapid onset of symptoms (5-10 hours) following exposure to the fumes flu-like symptoms fever, rigors, arthralgia, myalgia, headache[radiopaedia.org]

Workup

The rare appearance of polymer fume fever today can be challenging for the physician. For this reason, a detailed patient history is of crucial importance in order to arrive at a diagnosis [2] [4]. Basic features of symptoms (their pattern, time of onset, and duration) should be assessed, together with an occupational history that will reveal to which hazardous compounds the individual exposed to. Inhalation of fumes in households during cooking might also be a route of exposure [5], further emphasizing the essential role of a detailed assessment of activities that preceded the onset of symptoms. Imaging studies of the lungs may be necessary when severe symptoms are present, but it is not uncommon for chest X-rays to yield normal findings [6]. However, consolidation and patchy infiltration of the lungs might be observed on plain radiography or computed tomography (CT) [1] [6]. Pulmonary edema, although being a rare entity in polymer fume fever, can be seen as a bilateral ground-glass opacity or consolidation on CT [8]. Other notable findings in the workup include reduced lung capacity on pulmonary function testing, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) [3] [6] [7].

Treatment

  • Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.[book-med.info]
  • TREATMENT: The primary treatment for both metal fume fever and polymer fume fever is supportive and directed at symptom relief.[ncbi.nlm.nih.gov]
  • Avoidance of the fumes is the treatment. See: metal fume fever[medical-dictionary.thefreedictionary.com]
  • : marked influx of neutrophils Clinical (onset of symptoms 4-8 hrs after acute inhalation of fumes or dust) Mild Dyspnea (see Dyspnea , [[Dyspnea]]) Cough (see Cough , [[Cough]]) Fever (see Fever , [[Fever]]) Flu-Like Syndrome Malaise Chills Myalgia Treatment[mdnxs.com]

Prognosis

  • PROGNOSIS: Metal fume fever is typically a benign and self-limited disease entity that resolves over 12-48 h following cessation of exposure.[ncbi.nlm.nih.gov]
  • Treatment and prognosis Treatment tends to be supportive and in the vast majority recovery is rapid. No deaths have been recorded. History and etymology First published case is from 1831 1 .[radiopaedia.org]

Etiology

  • The etiology is most likely multifactorial. Future research should focus on determining the exact mechanism of illness and establishing safe exposure limits. Publisher Full Text Polymer fume fever.[unboundmedicine.com]
  • Mill fever Symptoms: flu-like illness with rhinitis; Signs: leucocytosis; normal chest x-ray; Onset after exposure; 1-6 hours; Heavy exposure to: dusts of cotton, flax, soft hemp, or kapok; Resolution: few hours to few days; Comments: A common etiology[haz-map.com]

Epidemiology

  • EPIDEMIOLOGY: Metal fume fever occurs most commonly as an occupational disease in individuals who perform welding and other metal-joining activities for a living.[ncbi.nlm.nih.gov]
  • […] interaction Eskalith CR and haloperidol interaction Lithane and haloperidol interaction Lithobid and haloperidol interaction more interactions. » Similar articles: Toddler Fever 102 Fevers Diet During Fever in Children Guide for Fever Diagnosis and Treatment Epidemiology[book-med.info]
Sex distribution
Age distribution

Pathophysiology

  • PATHOPHYSIOLOGY: While the precise pathophysiology associated with the development of metal fume fever is yet to be elucidated, suggested pathophysiologic mechanisms include pro-inflammatory cytokine release, neutrophil activation, and oxygen radical[ncbi.nlm.nih.gov]

Prevention

  • While no serious consequences were observed, the effects of these illnesses upon the health and productivity of the group could have been prevented.[jamanetwork.com]
  • We undertook a review of the peer-reviewed medical literature as it relates to these two disease entities in order to describe their epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, prevention, and prognosis.[ncbi.nlm.nih.gov]
  • Until… … Wikipedia Perfluoroisobutene — IUPAC name 1,1,3,3,3 pentafluoro 2 (trifluoromethyl)prop 1 ene … Wikipedia Non-stick pan — A non stick pan Non stick pans are cooking pans made from or coated with materials designed to prevent food from sticking[medicine.academic.ru]
  • It is desirable to prevent exposure to such fume altogether by the use of efficient fume extraction. Any surface coatings on steel must be identified before welding or cutting.[twi-global.com]
  • The good news is that action is being taken to prevent the use of ‘controversial’ chemicals in the manufacture of Teflon and products.[healthguidance.org]

References

Article

  1. Shusterman DJ. Polymer fume fever and other fluorocarbon pyrolysis-related syndromes. Occup Med. 1993;8:519–531.
  2. Centers for Disease Control (CDC). Polymer-fume fever associated with cigarette smoking and the use of tetrafluoroethylene--Mississippi. MMWR Morb Mortal Wkly Rep. 1987;36(31):515-5166, 521-522.
  3. Son M, Maruyama E, Shindo Y, Suganuma N, Sato S, Ogawa M. Case of polymer fume fever with interstitial pneumonia caused by inhalation of polytetrafluoroethylene (Teflon). Chudoku Kenkyu 2006;19:279–282.
  4. Shimizu T, Hamada O, Sasaki A, Ikeda M. Polymer fume fever. BMJ Case Rep. 2012;2012:bcr2012007790.
  5. Kales SN Christiani DC . Progression of chronic obstructive pulmonary disease after multiple episodes of an occupational inhalation fever. J Occup Med 1994;36:75–78.
  6. Greenberg MI, Vearrier D. Metal fume fever and polymer fume fever. Clin Toxicol (Phila). 2015;53(4):195-203.
  7. Sharman P, Wood-Baker R. Interstitial lung disease due to fumes from heat-cutting polymer rope. Occup Med (Lond). 2013;63(6):451-453.
  8. Hamaya R, Ono Y, Chida Y, et al. Polytetrafluoroethylene fume-induced pulmonary edema: a case report and review of the literature. J Med Case Rep. 2015;9:111.

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Last updated: 2019-07-11 21:26