Successful Treatment of Lipoid Pneumonia with Steroid-A Case Report and Literature Review

Lipoid pneumonia is an uncommon disease that results from pulmonary accumulation of a fat-like component. The diagnosis is based on clinical history, radiologic presentation and bronchoalveolar lavage (BAL) sample analysis. We report the case of a 46-year-old male who presented with cough, fever and pleuritic chest pain after diesel oil aspiration. Chest radiograph on admission revealed consolidation in the right lower lung field; an antibiotic was administered to treat aspiration pneumonia. Bronchoscopy revealed some oily, transparent, yellowish fluid in the right lower bronchus, but culture and cytology of BAL fluid showed negative results. The follow-up chest radiograph revealed no obvious improvement after antibiotic treatment. Chest computed tomography (CT) revealed consolidation in the right middle lobe with heterogeneous density, and CT-guided biopsy revealed necrotizing inflammation. A follow-up bronchoscopy showed mucosal inflammation. Steroid was administered to treat the lipoid pneumonia and inflammation, and obvious improvement of the clinical symptoms and radiologic manifestations was seen. No specific adverse effect or complication was noted during therapy. In patients with lipoid pneumonia, careful history-taking and diagnosis are important. Steroid is effective for these patients.