"Diesel siphoner′s lung": Exogenous lipoid pneumonia following hydrocarbon aspiration

Abstract

Lipoid pneumonia is an unusual and uncommon form of pneumonia caused by aspiration of fatty substances. Hydrocarbon pneumonitis following aspiration of diesel is a form of exogenous lipoid pneumonia wherein, aspirated diesel reaches the alveoli rapidly without evoking any significant cough, but initiates an intense inflammatory reaction in the pulmonary parenchyma. This is a rarely described clinical scenario, although the practice of diesel siphonage from automobiles is a common practice in developing countries. We herein describe a 40-year-old male patient, in whom the diagnosis of lipoid pneumonia was delayed for a long duration and highlight the importance of taking a detailed occupational exposure history in patients with non-resolving pneumonia to rule out the underlying possibility of this rare clinical entity.

Idiopathic Lipoid Pneumonia: An incidental finding in autopsy specimen

“…Apart from case reports of lipoid pneumonia in children treated with mineral oil-based nasal drops for common cold and in adults with oily laxative abuse, some other reported risk factors include nasopharyngeal anatomic defects or neuromuscular weakness predisposing to aspiration, extremes of age, recurrent loss of consciousness, occupational exposure in fire eaters 4 and forceful feeding of animal fat in children with a view to regularize bowel habits. 3,5 Exogenous lipoid pneumonia has also been described with the use of petroleum jelly, milk, poppy seed oil, and egg yolk. It has also been reported in patients with prolonged facial application of petrolatum for erythrodermic psoriasis.…”

“…The idiopathic form has been described in healthy smokers. 3 The pathophysiology of lipoid pneumonia is not clearly understood. Lipids float on the surface of gastric fluids.…”

“…The idiopathic form, also rare, has been described in smokers. 3 Herein, we present the case of a 53-year-old deceased male whose heart and a piece of one of the lungs was received after post-mortem for histopathological examination in our department.…”

Occupational Exogenous Lipoid Pneumonia: A Commonly Delayed Diagnosis

“…Our patient demonstrated improvement following avoidance of multipurpose grease. Systemic corticosteroids have been shown to be effective in some cases (2,4). Total pulmonary lavage has also been reported to be useful in the cortico-resistant form (6).…”

Teppanyaki/Hibachi Pneumonitis: An Exotic Cause of Exogenous Lipoid Pneumonia

“…The mechanism of injury is thought to occur after flame blowing, when the fire-eater takes a deep inspiration, and Kerdan remaining in the mouth can be aspirated [7–10]. Diesel siphoner's lung is a hydrocarbon pneumonitis described in individuals who transfer or steal gasoline from vehicles using a tube or a hose, where the individual draws the fluid with negative inspiratory force, often aspirating small quantities into the airway and lungs, “perhaps exacerbated by the rush of the moment!”, triggering a similar inflammatory pulmonary reaction caused by petroleum hydrocarbons [11–14]. …”