Abstract
Background: Exogenous lipoid pneumonia (ELP) may result from routine oil administration in childhood and should not go unrecognized.
Objectives: To describe the clinical-radiological-pathological characteristics and treatment outcomes of paediatric ELP, and elucidate oil administration practices.
Methods: We conducted a retrospective case series of children with histologically-confirmed ELP at Red Cross Children’s Hospital, South Africa. Caregivers were interviewed to understand oil administration practices.
Results: Twelve children, all of Zimbabwean heritage aged 2.1-10.8 months were identified between 2012 and 2017. Repeated administration of plant-based oil for cultural reasons was reported by 10/11 caregivers. Cough (12/12), tachypnea (11/12), hypoxia (9/12) and diffuse alveolar infiltrates on chest radiography (12/12) were common at presentation. Chest computed tomography commonly revealed ground glass opacification with lower zone predominance (9/9) and interlobular septal thickening (8/9). All bronchoalveolar lavage specimens appeared cloudy/milky with abundant lipid laden macrophages and extracellular lipid on Oil-Red-O staining, and documented polymicrobial (6/12) and Mycobacterium abscessus (2/12) co-infection. Antibiotics, systemic corticosteroids and therapeutic partial lung lavage were interventions in all, 8 and 5 patients respectively. Median time to clinical resolution was 1.1 months IQR (0.5-8.0) while radiological resolution was only documented in 2/12 cases.
Conclusion: ELP in young children resembles pulmonary alveolar proteinosis. Health workers should explicitly probe for a history of oil administration in children with non-resolving pneumonia, particularly if of Zimbabwean descent.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA2238.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018