Hydrocarbon pneumonitis caused by fire-eating

fire-eaterEfrosni Myloniki and colleagues, from Thessaloniki in Greece, report a case of a 16-year old boy  presenting with  dyspnea, cough, chest pain and fever after  fire-eating at a party.

A  chest  radiograph showed  infiltration  in  the  right  middle  lobe  which  was  diagnosed  as  aspiration pneumonia, and the patient was treated with antibiotics.

However, after five days, the patient’s condition deteriorated, and he was referred to a pulmonary clinic.

Spirometry revealed severe restriction of lung function, and a CT scan of the chest showed consolidation with an air bronchogram  in  the  right middle lobe, and areas of atelectasis and ground glass opacities in the middle and lower right lobes. Bronchoalveolar  lavage  fluid was hemorrhagic and  revealed cytoplasmic vacuolation of the macrophages,  lipid-laden  alveolar macrophages and neutrophilia.

These findings, and the use of liquid paraffin in the fire-eating routine, led the team to a diagnisis of hydrocarbon pneumonitis. The patient was treated successfully with systemic steroids and intravenous antibiotics.

Read the full case report for more details of the case, including images from the CT scans.

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