Foreign body granulomatosis in a patient with a factitious disorder.

A 42-year-old woman was hospitalized with fever and hypoxemia. The workup for fever was unrevealing. A computed tomographic scan of the chest showed centrilobular, small, nodular opacities throughout both the lung fields. A flexible bronchoscopy with transbronchial biopsy was performed. Pathology specimens consisted of intravascular foreign material with birefringent properties suggestive of microcrystalline cellulose. It was later determined that the patient was self-injecting herself with crushed pill fragments through a tunneled central venous catheter. The central venous catheter was removed and fever resolved.