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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Main Authors: Taylor Sanders, Mitchell Hymowitz, Christine Murphy
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2024-07-01
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.
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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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