Acute exogenous lipoid pneumonia leading to severe ARDS: a case report

Abstract Background 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 neu...

Full description

Saved in:
Bibliographic Details
Main Authors: Youdi Ye, Hui Cai, Chunfeng Dai, Qin Hu, Qiaoqiao Cao, Jing Bi, Yuanlin Song, Jinjun Jiang, Shujing Chen
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-025-03780-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849403043631595520
author Youdi Ye
Hui Cai
Chunfeng Dai
Qin Hu
Qiaoqiao Cao
Jing Bi
Yuanlin Song
Jinjun Jiang
Shujing Chen
author_facet Youdi Ye
Hui Cai
Chunfeng Dai
Qin Hu
Qiaoqiao Cao
Jing Bi
Yuanlin Song
Jinjun Jiang
Shujing Chen
author_sort Youdi Ye
collection DOAJ
description Abstract Background 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. Case presentation 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. Conclusion 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. Clinical trial number Not applicable.
format Article
id doaj-art-34731ae3e38646b7965bf810855a5cd8
institution Kabale University
issn 1471-2466
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Pulmonary Medicine
spelling doaj-art-34731ae3e38646b7965bf810855a5cd82025-08-20T03:37:22ZengBMCBMC Pulmonary Medicine1471-24662025-07-012511910.1186/s12890-025-03780-0Acute exogenous lipoid pneumonia leading to severe ARDS: a case reportYoudi Ye0Hui Cai1Chunfeng Dai2Qin Hu3Qiaoqiao Cao4Jing Bi5Yuanlin Song6Jinjun Jiang7Shujing Chen8Department of Pulmonary and Critical Care Medicine, Huangshan People’s HospitalDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Fudan UniversityDepartment of Pathology, Zhongshan Hospital, Fudan UniversityDepartment of Pulmonary and Critical Care Medicine, Nantong Haimen District People’s HospitalDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan UniversityDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan UniversityDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan UniversityDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan UniversityAbstract Background 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. Case presentation 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. Conclusion 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. Clinical trial number Not applicable.https://doi.org/10.1186/s12890-025-03780-0Exogenous lipoid pneumoniaAcute respiratory distress syndromeBronchoalveolar lavageMechanical ventilationProne position ventilation
spellingShingle Youdi Ye
Hui Cai
Chunfeng Dai
Qin Hu
Qiaoqiao Cao
Jing Bi
Yuanlin Song
Jinjun Jiang
Shujing Chen
Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
BMC Pulmonary Medicine
Exogenous lipoid pneumonia
Acute respiratory distress syndrome
Bronchoalveolar lavage
Mechanical ventilation
Prone position ventilation
title Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
title_full Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
title_fullStr Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
title_full_unstemmed Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
title_short Acute exogenous lipoid pneumonia leading to severe ARDS: a case report
title_sort acute exogenous lipoid pneumonia leading to severe ards a case report
topic Exogenous lipoid pneumonia
Acute respiratory distress syndrome
Bronchoalveolar lavage
Mechanical ventilation
Prone position ventilation
url https://doi.org/10.1186/s12890-025-03780-0
work_keys_str_mv AT youdiye acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT huicai acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT chunfengdai acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT qinhu acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT qiaoqiaocao acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT jingbi acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT yuanlinsong acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT jinjunjiang acuteexogenouslipoidpneumonialeadingtosevereardsacasereport
AT shujingchen acuteexogenouslipoidpneumonialeadingtosevereardsacasereport