Frontiers in pediatrics · 2026
Pediatric exogenous lipoid pneumonia caused by paraffin oil aspiration: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Tian Dingbo, Nie Bayu, Duan Junhong
Аннотация
OBJECTIVE: This case report describes a rare pediatric case of exogenous lipoid pneumonia caused by repeated paraffin oil aspiration and highlights the importance of detailed exposure history, early recognition, and timely intervention.
CASE PRESENTATION: We report the clinical course, diagnostic assessment, treatment, and follow-up of a 4-month-old former preterm infant admitted to the pediatric intensive care unit with severe pneumonia.
RESULTS: Repeated targeted history-taking revealed multiple oral administrations of liquid paraffin with choking episodes. Chest CT showed bilateral consolidation, ground-glass opacities, interlobular septal thickening, a crazy-paving pattern, and a focal area of fat attenuation. BALF cytology showed vacuolated histiocytes, although lipid-specific staining was unavailable. Klebsiella aerogenes was detected by throat-swab and BALF targeted next-generation sequencing and was isolated from sputum culture, supporting concomitant lower respiratory tract infection. Following discontinuation of paraffin exposure and multimodal management, the patient showed clinical and radiological improvement.
CONCLUSION: Exogenous lipoid pneumonia should be considered in infants with treatment-refractory pneumonia and intralesional fat attenuation on CT. Diagnosis requires integration of exposure history, imaging, BALF findings, microbiological evidence, and clinical course. Because several interventions were administered concurrently and long-term follow-up was incomplete, the efficacy of individual treatments and late pulmonary outcomes could not be determined.
CASE PRESENTATION: We report the clinical course, diagnostic assessment, treatment, and follow-up of a 4-month-old former preterm infant admitted to the pediatric intensive care unit with severe pneumonia.
RESULTS: Repeated targeted history-taking revealed multiple oral administrations of liquid paraffin with choking episodes. Chest CT showed bilateral consolidation, ground-glass opacities, interlobular septal thickening, a crazy-paving pattern, and a focal area of fat attenuation. BALF cytology showed vacuolated histiocytes, although lipid-specific staining was unavailable. Klebsiella aerogenes was detected by throat-swab and BALF targeted next-generation sequencing and was isolated from sputum culture, supporting concomitant lower respiratory tract infection. Following discontinuation of paraffin exposure and multimodal management, the patient showed clinical and radiological improvement.
CONCLUSION: Exogenous lipoid pneumonia should be considered in infants with treatment-refractory pneumonia and intralesional fat attenuation on CT. Diagnosis requires integration of exposure history, imaging, BALF findings, microbiological evidence, and clinical course. Because several interventions were administered concurrently and long-term follow-up was incomplete, the efficacy of individual treatments and late pulmonary outcomes could not be determined.