Mineral Oil Pneumonia

Abstract

A case of mineral oil pneumonia in a 55-year-old white male is presented. Diagnosis was established by [1] history of ingestion of unusual amounts of mineral oil in a patient with esophageal structure and dysphagia, [2] radiographic appearance of the lungs, and [3] meticulous sputum examination revealing typical oil droplets in macrophages and extracellularly. There are no detailed reports of pulmonary function in such cases in the literature. In the case presented, the physiologic findings include: 1. Markedly decreased vital capacity and pulmonary compliance, with increased residual volume and RV/TLC ratio. 2. Decreased maximal breathing capacity with increased pulmonary airway resistance and air trapping. 3. Arterial oxygen saturation slightly reduced at rest and markedly reduced on exercise, with elevated pCO2 and compensated respiratory acidosis. 4. Normal diffusing capacity of the lung for oxygen at rest and increased venous admixture. The physiologic findings are thought to result from the pulmonary fibrotic and broncho-inflammatory reactions to the aspirated mineral oil, and are consistent with the clinical and pathologic features of mineral oil pneumonia described in the literature.