Open AccessExogenous lipoid pneumonia: an important cause of interstitial lung disease in infants
Author(s) -
Marangu Diana,
Pillay Komala,
Banderker Ebrahim,
Gray Diane,
Vanker Aneesa,
Zampoli Marco
Publication year - 2018
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.356
Subject(s) - medicine , bronchoalveolar lavage , pulmonary alveolar proteinosis , pneumonia , lung , antibiotics , pathology , gastroenterology , microbiology and biotechnology , biology
Exogenous lipoid pneumonia (ELP), an important cause of interstitial lung disease, often goes unrecognized. We conducted a retrospective study of children with histologically confirmed ELP at Red Cross Children’s Hospital, South Africa. Twelve children of Zimbabwean heritage aged 2.1–10.8 months were identified between 2012 and 2017. Repeated oral administration of plant‐based oil for cultural reasons was reported by 10 of 11 caregivers. Cough (12/12), tachypnoea (11/12), hypoxia (9/12), and diffuse alveolar infiltrates on chest radiography (12/12) were common at presentation. Chest computed tomography revealed ground‐glass opacification with lower zone predominance (9/9) and interlobular septal thickening (8/9). Bronchoalveolar lavage specimens appeared cloudy/milky, with abundant lipid‐laden macrophages and extracellular lipid on Oil‐Red‐O staining (12/12), with polymicrobial (6/12) and Mycobacterium abscessus (2/12) co‐infection. Antibiotics, systemic corticosteroids, and therapeutic lavage were interventions in all eight and five patients, respectively. Clinicians should consider ELP in children with non‐resolving pneumonia in settings with similar practices.