[Clinical characteristics of lipid aspiration pneumonia in 16 children].
OBJECTIVE
To investigate clinical characteristics and changes of pulmonary imaging of mineral oil aspiration pneumonia in children.


METHODS
The clinical features, CT findings, and effects of corticosteroid therapy were analyzed in 16 children with mineral oil aspiration pneumonia, who were hospitalized in our hospital from January 2003 to July 2013.


RESULTS
All patients with mineral oil aspiration pneumonia had a history of mineral oil administration.Four patients had no clinical manifestations. Ten cases presented fever, and 8 of the 10 patients had fever in 4-8 h after taking mineral oil, and the temperature was between 39-40 °C. There were wheezing in 2 cases, shortness of breath in 6 cases, cyanosis in 1 case, dyspnea in 3 cases, and moaning in 2 cases, chest pain in 1 case, headache and abnormal EEG in 1 case.Six patients had rales in lungs. Peripheral blood white cells increased in 10 cases, and C- reactive protein elevated in 7 patients. Chest CT examination showed abnormal findings in 6 children, and the earliest CT was performed within 2 h after the accident. The rest 10 children got chest X-ray, and 9 of 10 children had abnormal findings. The earliest X-ray was done within 3 h after the accident. And the remaining 1 of 10 children showed no significant changes in the first chest X-ray 2-3 h after the accident until 3 days. All of the patients received corticosteroid and antibiotic treatments, 4 cases underwent bronchoalveolar lavage, 3 patients were given albumin, 6 cases received intravenous immunoglobulin. Three cases delayed in treatment with hormone because of misdiagnosis, and 2 of them had clearly secondary infections. Twelve patients recovered completely from oil aspiration pneumonia after 8 days to 5.5 months.


CONCLUSIONS
Oil aspiration pneumonia in children occurs in almost all cases after mineral oil aspiration. Pulmonary opacities can be found by chest CT in most patients within 24 hours after mineral oil aspiration. Corticosteroids therapy was effective for patients with exogenous lipid pneumonia, which may inhibit the inflammatory response and possible pulmonary fibrosis.
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Lisha
L
Ge
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Sihu
S
Chen
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Miaomiao
M
Lin
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Xiaojiao
X
Xia
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Yimei
Y
Jin
Department of Emergency Medicine, Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China. Email: heicu@163.com.
Shijun
S
He
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008899:Mineral Oil / Q000009:adverse effects; D011017:Pneumonia, Lipid / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D008899:Mineral Oil; D002097:C-Reactive Protein