Ye Youdi, Cai Hui, Dai Chunfeng, Hu Qin, Cao Qiaoqiao, Bi Jing, Song Yuanlin, Jiang Jinjun, Chen Shujing
Department of Pulmonary and Critical Care Medicine, Huangshan People's Hospital, Huangshan, Anhui, China.
Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
BMC Pulm Med. 2025 Jul 2;25(1):306. doi: 10.1186/s12890-025-03780-0.
Exogenous lipoid pneumonia, a form of pneumonia caused by the aspiration of lipid substances, is often associated with the use of mineral oil. Historically, cases have predominantly been reported in young children, elderly, or individuals with compromised physical strength or neurological disorders, with the majority presenting as mild or chronic conditions. Upon cessation of exposure to lipids, symptoms typically showed improvement.
We report a case of a previously healthy middle-aged man who developed respiratory failure and severe acute respiratory distress syndrome (ARDS) following the accidental aspiration of sewing machine oil, and a chest computed tomography (CT) scan revealed consolidations in both lungs, with local attenuation visible in the mediastinal window. Lipid vacuoles were observed in the bronchoalveolar lavage fluid, and Oil Red O staining was positive, confirming the diagnosis. In terms of treatment, invasive mechanical ventilation was provided, along with intermittent prone positioning ventilation, segmented alveolar lavage, and systemic corticosteroids as part of a comprehensive treatment approach. The patient's oxygenation gradually improved, leading to stabilization, and follow-up chest CT three months later showed resolution of the lung lesions.
The diagnosis of exogenous lipoid pneumonia is based on a history of lipid exposure, chest imaging, and the presence of lipid-laden macrophages in bronchoalveolar lavage fluid. However, there is currently no established treatment protocol. For critically ill patients, life support measures are crucial during the early stages or peak of the disease.
Not applicable.
外源性类脂性肺炎是一种由脂质物质吸入引起的肺炎，常与矿物油的使用有关。从历史上看，病例主要报道于幼儿、老年人或体力受损或患有神经系统疾病的个体，大多数表现为轻度或慢性疾病。停止接触脂质后，症状通常会有所改善。
我们报告一例既往健康的中年男性，在意外吸入缝纫机机油后发生呼吸衰竭和严重急性呼吸窘迫综合征（ARDS），胸部计算机断层扫描（CT）显示双肺实变，纵隔窗可见局部衰减。支气管肺泡灌洗液中观察到脂质空泡，油红O染色呈阳性，确诊。在治疗方面，采用有创机械通气，同时进行间歇性俯卧位通气、分段肺泡灌洗和全身使用皮质类固醇作为综合治疗方法的一部分。患者的氧合逐渐改善，病情趋于稳定，三个月后的胸部CT随访显示肺部病变消退。
外源性类脂性肺炎的诊断基于脂质接触史、胸部影像学检查以及支气管肺泡灌洗液中存在含脂质巨噬细胞。然而，目前尚无既定的治疗方案。对于重症患者，在疾病早期或高峰期，生命支持措施至关重要。
不适用。
