Therapeutic Lung Lavage in Severe Exogenous Lipoid Pneumonia Following Sewing Machine Oil Ingestion

Exogenous lipoid pneumonia (ELP) is an uncommon inflammatory lung disease caused by aspiration of lipid substances and may progress to respiratory failure. We report a 4-y-old child who developed respiratory distress following sewing machine oil ingestion. Imaging revealed bilateral consolidation with multiple pneumatoceles complicated by bilateral pneumothoraces requiring intercostal drainage. Despite supportive care and corticosteroid therapy, the child developed respiratory failure necessitating mechanical ventilation, tracheostomy, and pleurodesis for persistent pneumothoraces. Repeat chest computed tomography demonstrated characteristic fat attenuation suggestive of ELP. In view of persistent respiratory distress and inability to wean off from ventilation, partial bilateral therapeutic lung lavage was performed, yielding milky-white fluid, following which gradual improvement was observed and ventilatory support was successfully weaned.