A Case of Exogenous Lipoid Pneumonia due to Inhalation of Domestic Insecticide

Abstract

A 21-year-old man was admitted to our hospital because of fever, cough, bloody sputum and dyspnea. He had been treated for depression and other psychosomatic diseases since the age of 20 years. The night before admission, he came home very drunk and inhaled domestic insecticide which he mistook for oxygen spray. On admission, he was hypoxic and chest X-ray revealed infiltration in both lower lobes. Bronchoscopic lung biopsy was attempted but cytologic diagnosis was not possible because of poor patient cooperation. Gas chromatographical analysis of the bronchial lavage fluid revealed an oil component (kerosene) contained in the inhaled insecticide. Consequently, extrinsic lipoid pneumonia was strongly suspected. During hospitalization, pleural effusion and nodular shadows were observed by chest X-ray, although these conditions improved with steroid treatment.