Exogenous lipoid pneumonia in infant

OBJECTIVES: To report a case of an exclusive breastfeeding infant who developed pneumonia after bronchoaspiration of mineral oil for the treatment of intestinal pseudoconstipation. CASE REPORT: LGZ, male, 5 months old, previously healthy, exclusive breastfeeding, with maternal report of absence of evacuation for six days. She sought medical attention at the basic health unit (UBS), where mineral oil was prescribed and later, discharged home. She reported that when administering mineral oil the patient had a choking crisis followed by cough and vomiting. After four hours of the event he was brought to the emergency room due to grunting. He checked in presenting regular to poor general condition, tearful, tachypneic, with nasal obstruction and grunting, saturation oxygen 90% in ambient air. Non-invasive supportive measures were taken, followed by infectious screening and chest radiography. We chose immediate initiation of parenteral antibiotic therapy for exogenous lipoid pneumonia. He was admitted to the nursery for 10 days, received corticosteroid therapy (methylprednisolone 2mg/kg/day) and antibiotic therapy with amikacin (15mg/kg/day) and clindamycin (30mg/kg/dose) for secondary infection coverage. During hospitalization, the patient underwent chest computed tomography on the 3rd day and bronchoalveolar lavage was collected on the 9th day. He got better as expected and soon discharged after 10 days of hospitalization, in good general condition, eupneic, remaining in outpatient follow-up, without apparent sequelae. CONCLUSIONS: Lipoid pneumonia is a potentially fatal condition, caused by alveolar filling with oil. The main treatment is the immediate suspension of mineral oil.