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Not Your Typical Pneumonia: A Case of Exogenous Lipoid Pneumonia

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Abstract

The constellation of chronic cough, dyspnea, and hemoptysis can include a broad range of differential diagnoses. Although uncommon, exogenous lipoid pneumonia (ELP) should be considered when patients present with this symptom complex. We report a case of a 72-year-old female who presented with hemoptysis, cough, and dyspnea. The admission computed tomography scan of the chest revealed progressive interstitial infiltrates. Bronchoscopy revealed diffuse erythema without bleeding. Culture and cytology of lavage fluid were negative. Open-lung biopsy revealed numerous lipid-laden macrophages and multinucleated foreign-body giant cells. On further questioning, the patient admitted to the daily use of mineral oil for constipation. The diagnosis of ELP was made. The literature review revealed that many cases typically present with chronic cough with or without dyspnea. Our case illustrates an unusual presenting symptom of hemoptysis and the need to identify patients who can be at risk of developing this rare condition.

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Acknowledgements

I would like to acknowledge the Department of Pathology at the University of Kansas for providing the slides on our patient. There was no funding for the writing of this manuscript.

Conflict of Interest Statement

None Disclosed.

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Authors and Affiliations

  1. Division of General and Geriatric Medicine, University of Kansas Medical Center, Mail stop 1020, Wescoe 5026, 3901 Rainbow Boulevard, Kansas, KS, 66160, USA

    Ashley Simmons MD

  2. Division of General Internal Medicine, University of Missouri—Kansas City School of Medicine, Kansas, MO, USA

    Emran Rouf MD

  3. Primary Care Division, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA

    Jeff Whittle MD, MPH

  4. Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Jeff Whittle MD, MPH

Authors
  1. Ashley Simmons MD
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  2. Emran Rouf MD
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  3. Jeff Whittle MD, MPH
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Correspondence to Ashley Simmons MD.

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Simmons, A., Rouf, E. & Whittle, J. Not Your Typical Pneumonia: A Case of Exogenous Lipoid Pneumonia. J GEN INTERN MED 22, 1613–1616 (2007). https://doi.org/10.1007/s11606-007-0280-7

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  • DOI: https://doi.org/10.1007/s11606-007-0280-7

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