Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report
Introduction: Metallic luster dusts are decorative agents for cakes and other confections. While some powders are labeled “non-edible,” they are also marketed as “non-toxic.” We present a case of a child who developed acute metal pneumonitis after accidental aspiration of metallic luster dust. Case...
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eScholarship Publishing, University of California
2024-07-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/7xg3t40d |
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| author | Taylor Sanders Mitchell Hymowitz Christine Murphy |
| author_facet | Taylor Sanders Mitchell Hymowitz Christine Murphy |
| author_sort | Taylor Sanders |
| collection | DOAJ |
| description | Introduction: Metallic luster dusts are decorative agents for cakes and other confections. While some powders are labeled “non-edible,” they are also marketed as “non-toxic.” We present a case of a child who developed acute metal pneumonitis after accidental aspiration of metallic luster dust. Case Report: A four-year-old presented to the emergency department (ED) in respiratory distress after attempting to ingest gold decorative metallic luster dust. In the ED she was placed on supplemental oxygen. Her initial chest radiograph (CXR) was unremarkable. Her condition worsened despite high-flow nasal cannula oxygen, and she was intubated. A repeat CXR revealed patchy perihilar and peribronchial opacities. While receiving aggressive ventilatory support, her CXR worsened over the next 48 hours as bilateral interstitial and alveolar opacities progressed, likely representing acute metal pneumonitis with acute respiratory distress syndrome (ARDS). She remained intubated until hospital day (HD) 5, requiring supplemental oxygen until HD 9. She was discharged home on HD 10. A CXR obtained four months later demonstrated increased interstitial markings throughout both lungs with overinflation and subsegmental atelectasis. The patient had persistent dyspnea upon exertion, with pulmonology documenting that her symptoms were likely sequelae from inhalation of the cake luster dust. Conclusion: Non-edible metallic cake dusts are toxic. “Non-edible” labeling does not convey the health risks associated with handling by children, as evidenced by this case of metal pneumonitis with associated ARDS and chronic pulmonary disease. Accordingly, this descriptor should be abandoned for these products, and physicians should be aware of this potential complication. |
| format | Article |
| id | doaj-art-65cfd7618c0d452ab793cbc2e0819e2d |
| institution | OA Journals |
| issn | 2474-252X |
| language | English |
| publishDate | 2024-07-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-65cfd7618c0d452ab793cbc2e0819e2d2025-08-20T02:01:19ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2024-07-018433233510.5811/cpcem.7220cpcem-8-332Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case ReportTaylor Sanders0Mitchell Hymowitz1Christine Murphy2Atrium Health’s Carolinas Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Charlotte, North CarolinaLouisiana State University Health Sciences Center, School of Medicine, Emergency Medicine Residency Program, Baton Rouge Campus, Baton Rouge, LouisianaAtrium Health’s Carolinas Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Charlotte, North CarolinaIntroduction: Metallic luster dusts are decorative agents for cakes and other confections. While some powders are labeled “non-edible,” they are also marketed as “non-toxic.” We present a case of a child who developed acute metal pneumonitis after accidental aspiration of metallic luster dust. Case Report: A four-year-old presented to the emergency department (ED) in respiratory distress after attempting to ingest gold decorative metallic luster dust. In the ED she was placed on supplemental oxygen. Her initial chest radiograph (CXR) was unremarkable. Her condition worsened despite high-flow nasal cannula oxygen, and she was intubated. A repeat CXR revealed patchy perihilar and peribronchial opacities. While receiving aggressive ventilatory support, her CXR worsened over the next 48 hours as bilateral interstitial and alveolar opacities progressed, likely representing acute metal pneumonitis with acute respiratory distress syndrome (ARDS). She remained intubated until hospital day (HD) 5, requiring supplemental oxygen until HD 9. She was discharged home on HD 10. A CXR obtained four months later demonstrated increased interstitial markings throughout both lungs with overinflation and subsegmental atelectasis. The patient had persistent dyspnea upon exertion, with pulmonology documenting that her symptoms were likely sequelae from inhalation of the cake luster dust. Conclusion: Non-edible metallic cake dusts are toxic. “Non-edible” labeling does not convey the health risks associated with handling by children, as evidenced by this case of metal pneumonitis with associated ARDS and chronic pulmonary disease. Accordingly, this descriptor should be abandoned for these products, and physicians should be aware of this potential complication.https://escholarship.org/uc/item/7xg3t40d |
| spellingShingle | Taylor Sanders Mitchell Hymowitz Christine Murphy Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report Clinical Practice and Cases in Emergency Medicine |
| title | Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report |
| title_full | Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report |
| title_fullStr | Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report |
| title_full_unstemmed | Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report |
| title_short | Metal Pneumonitis from “Non-toxic” Decorative Cake Dust Aspiration: A Case Report |
| title_sort | metal pneumonitis from non toxic decorative cake dust aspiration a case report |
| url | https://escholarship.org/uc/item/7xg3t40d |
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