Exogenous Lipoid Pneumonia due to Chronic Inhalation of Oily Product Used as a Lubricant of Tracheotomy Cannula

Abstract

Exogenous lipoid pneumonia (ELP) is caused by the inhalation of vaporized oily products. Long-term exposurecan result in chronic disease, whereas acute form usually results from massive aspiration of fattysubstances. It has an incidence of 1.0%–2.5%.In case of symptomatic patients, the clinical presentation mainly includes acute or chronic respiratory symptomssuch as dyspnea, fever, cough and less frequently chest pain, hemoptysis, or weight loss. Radiologicalfindings are often aspecific or misinterpreted, and ELP is sometimes misdiagnosed as a malignancy of thelungs.Patient history and radiological findings can lead to a suspicion of ELP, but histological microscopic findings ofintra-alveolar lipid and lipid-laden macrophages are required to confirm the diagnosis The mainstay of treatmentconsists of avoiding ongoing exposure and providing supportive care as repeated whole-lung lavage,corticosteroids, and/or immunoglobulins. Surgery is reserved for cases of high suspicion of cancer or seriousclinical impact (as recurrent infections).Prognosis is benign, even if it has been reported cases of progression to severe respiratory failure, cor pulmonale,superinfection, and association with lung cancer. Here, we describe a case of ELP due to chronicinhalation of oily product (Vaseline) used as a lubricant of tracheotomy cannula.