1/23. kerosene-induced severe acute respiratory failure in near drowning: reports on four cases and review of the literature.OBJECTIVE: The purpose of this study is to present an unusual respiratory and cardiovascular course after intoxication and near drowning in a river contaminated with kerosene. DESIGN: case reports and review of the literature. SETTING: intensive care unit of a university-affiliated hospital. patients: Four patients after near drowning. INTERVENTION: Supportive only. RESULTS: The four patients developed acute respiratory failure. Cardiomyopathy was present in three patients and a persistent hypokalemia in two patients. The onset of the symptoms was delayed, which led to underestimation of the severity of their illness. Two of the four patients died. The diagnosis of hydrocarbon intoxication was based on bronchoalveolar lavage results, neutrophilic alveolitis with the presence of lipid-laden macrophages, and evidence of lipoid pneumonia from the autopsy performed on one victim. One patient who clinically deteriorated and another who developed a severe restrictive pulmonary disorder were treated with corticosteroids, which were effective only in the latter patient. CONCLUSIONS: Acute kerosene intoxication in a near-drowning event often results in severe respiratory and cardiac failure, with a high fatality rate. Treatment with corticosteroids may lead to a rapid improvement in lung function.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/23. Exogenous lipid pneumonia related to smoking weed oil following cadaveric renal transplantation.A 30-year-old female presented shortly after cadaveric renal transplantation with respiratory distress typical of a bacterial infection. Following initial improvement, she developed progressive respiratory failure, initially felt to be secondary to cytomegalovirus infection. Two bronchoalveolar lavages were nondiagnostic, and an open lung biopsy was performed, which revealed a pulmonary alveolar proteinosis (PAP) reaction and exogenous lipid pneumonia (ELP). The ELP was considered to be secondary to the use of marijuana, in the form of weed oil, that was smoked daily for over 10 years and stopped just before renal transplantation. This is the first description of both PAP and ELP following renal transplantation, and the first description of ELP related to smoking weed oil. physicians should be aware of the different forms of marijuana available and of their potential medical complications.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
3/23. Exogenous lipoid pneumonia following ingestion of liquid paraffin.An asymptomatic patient with exogenous lipoid pneumonia (ELP) due to silent aspiration of liquid paraffin ingested as a lubricant was diagnosed by bronchoalveolar lavage (BAL). BAL fluid separated into oily upper phase and lower aqueous phase spontaneously. Microscopic analysis of BAL cells revealed the presence of lipid-laden alveolar macrophages. Classic histochemical staining and electron microscope examination indicated that neutral lipid was dominant but phospholipid was also present in the lipid-laden macrophages. Together with the history of ingestion of liquid paraffin, we identified that the ingested liquid paraffin was the origin of the neutral lipid in the lipid-laden macrophages observed in the BAL fluid.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
4/23. Fatal lipoid pneumonia due to bronco-aspiration of isoparaffin after ingestion of an organophosphate insecticide.A 66-year-old-male patient with a history of depression voluntarily ingested around 400 ml of an insecticide composed of 5% methylparathion, 75% isoparaffin, 8% etoxylated oleic acid, 4% 1,2,4-trimethylbenzene, 6% naphtha, 1% 1,3,5- trimethylbenzene, 0.4% propylbenzene and 0.3% xylene. The patient was conscious and alert at admission. gastric lavage was performed and activated charcoal administered. There were no clinical symptoms of organophospate ingestion despite reduced concentrations of erythrocyte and plasma cholinesterase. Chest X-ray showed pulmonary infiltrate compatible with bronco-aspiration. The patient evolved to respiratory failure refractory to treatment and died from multiorganic failure 23 days after ingesting the insecticide. The pathological findings included a pulmonary fibrosis in the alveolar spaces which caused enlargement of the intra-alveolar septa. Abundant lipin-laden macrophages were observed within the alveolar spaces. We review the most relevant aspects of cases of fatal lipoid pneumonia and point out that on occasion severe or fatal intoxication is due to the substances accompanying the active ingredients.- - - - - - - - - - ranking = 3keywords = alveolar (Clic here for more details about this article) |
5/23. Ultrastructural changes in animal fat associated lipoid pneumonia: report of two cases.Traditional or cultural practices in different parts of the world where oils are used continue to produce lipoid pneumonia. We report the ultrastructural findings and observations in animal fat associated lipoid pneumonia from two children following a cultural practice of forced feeding with animal fat (ghee). Clinical findings showed an acute or chronic chest infection which failed to respond to anti-microbial therapy. X-ray and chest CT scan revealed collapse/consolidations of the right middle and left lower lobes. histology and electron microscopy revealed thickening and destruction of the alveolar septa, filling of alveolar spaces with red blood cells and macrophage which contained both primary and secondary lysosomes. The alveolar walls contained mostly type II pneumocyte with most of them surrounded by thickened basement membranes with only a small portion of their surfaces exposed directly to the alveolar space where it showed numerous microvilli.- - - - - - - - - - ranking = 4keywords = alveolar (Clic here for more details about this article) |
6/23. Coexisting endogenous lipoid pneumonia, cholesterol granulomas, and pulmonary alveolar proteinosis in a pediatric population: a clinical, radiographic, and pathologic correlation.Benign pulmonary diseases that have been associated with the accumulation of endogenous lipids within the alveoli, bronchioles, and interstitial tissues include endogenous lipoid pneumonia (ELP), pulmonary alveolar proteinosis (PAP), pulmonary interstitial and intra-alveolar cholesterol granulomas (PICG), various xanthomatous lesions, and malakoplakia. In ELP, fat-filled finely vacuolated macrophages fill the alveoli. In PAP, the aveoli become filled with cholesterol and periodic acid-Schiff (PAS)-positive acellular debris. In PICG, cholesterol esters are released from degenerating macrophages and, as organization occurs, the cholesterol is deposited in the form of acicular clefts within the interstitium. These morphologically distinct presentations of endogenous lipid deposition within the lung have long been thought to represent unique disease processes but several authors now postulate a possible relationship between these entities. We report here on the clinical, radiographic, and morphologic findings in eight pediatric patients with diverse primary disease processes who were subsequently found to have varying and often coexisting degrees of ELP, PAP, and PICG.- - - - - - - - - - ranking = 6keywords = alveolar (Clic here for more details about this article) |
7/23. False-positive PET scan in a patient with lipoid pneumonia simulating lung cancer.PURPOSE: Lipoid pneumonia usually presents with alveolar infiltrates or as a nonresolving process. We report a case of lipoid pneumonia that presented as a solitary pulmonary nodule and had a high standard uptake value on PET scan, thereby mimicking a malignant process. This case highlights the presence of false-positive PET imaging in a patient with lipoid pneumonia and mycobacterium chelonae infection. MATERIALS AND methods: The patient was examined using CT scanning. The nodule was further investigated with a PET scan using F-18 FDG and the standard uptake value was determined. RESULTS: Histopathology following removal of the nodule confirmed the diagnosis of lipoid pneumonia, and the bronchoalveolar lavage (BAL) was reported as M. chelonae, a rapidly growing mycobacterium (RGM). CONCLUSION: Lipoid pneumonia can present as a PET-positive lung nodule and should be considered in the differential diagnosis and workup of a solitary pulmonary nodule.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
8/23. Acute hydrocarbon pneumonia after white spirit aspiration: sequential HRCT findings.Hydrocarbon pneumonia is a very uncommon condition resulting from aspiration of mineral oil into the lung. We report the first description of early and sequential high-resolution computed tomographic (HRCT) findings of hydrocarbon pneumonia following attempted suicide by white spirit aspiration. Initial HRCT showed patchy opacities of coalescing masses with well-defined walls. They were visible in the middle lobe, lingula and lower lobes. Follow-up CT showed regression of the alveolar opacities, the presence of pneumatoceles and right asymptomatic pneumothorax. After 23 months of follow-up, the patient remained asymptomatic, and the follow-up CT scan was considered normal. The radiological features and a review of the relevant literature are briefly discussed.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
9/23. Unilateral lung infiltrate. Lipoid pneumonia.A case of unilateral lipoid pneumonia, proven by alveolar lavage and transbronchial lung biopsy, is presented. Following a stroke, which resulted in difficulty in swallowing, the patient slept only on his right side accounting for the unilateral lung infiltrate. He had been taking mineral oil for several years accounting for the lipoid pneumonia.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
10/23. GC/MS detection of paraffins in a case of lipoid pneumonia following occupational exposure to oil spray.A case of lipoid pneumonia following occupational exposure to oil spray is described. Biological fluids (broncho-alveolar lavage and pleural fluid) are analyzed to determine if the compounds found in the industrial oils are present. The samples are purified using high-performance thin-layer chromatography, and after extraction, the compounds were submitted to infrared spectroscopy. Direct hexane extraction of biological fluids is also performed, followed by gas chromatography/mass spectrometry (GC/MS).- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
| | Next -> |