Not typical pneumonia: acute exogenous lipoid pneumonia in 19 children

Aim: The aim of this study was to investigate clinical characteristics, radiological findings and therapies of ELP in healthy children. Methods: 19 children hospitalized in our hospital were retrospectively reviewed, with a mean age of 30 months (range: 14-60 months). The medical records including clinic manifestations, radiologic findings and treatments were analyzed. Results: There were 19 patients with diagnosed acute ELP caused by aspiration of mineral oil (machine oil in 12 cases, gasoline 3 cases, kerosene 3 cases and diesel 1 case). Diagnoses were based on clinical and x-ray or computed tomography (CT) findings (n=15) and bronchoalveolar lavage (n=4). All patients developed choking and cough immediately after ingestion of oil and 10 patients had vomited. 15 cases developed progressive fever, wheezing, shortness of breath, cyanosis, dyspnea, moaning uneasy, chest pain and so on. Chest CT scan showed abnormal in 18 children, except the rest one only received chest X-ray scan. Corticosteroid and antibiotic treatments were given to every child. 3 children received albumin transfusion, and 7 children received intravenous immunoglobulin. 15 patients recovered completely from oil aspiration pneumonia 8 days to 5.5 months later. Conclusion: ELP in children occurs in almost all cases after mistaking mineral oil. Pulmonary opacities can be found by chest CT in most patients within 24 hours after aspirating mineral oil. Clinical history and CT examination are very helpful for making a diagnosis of lipid pneumonia. Corticosteroids therapy was effective for patients with ELP which limited inflammatory response and ongoing pulmonary fibrosis.