INFANTILE LIPOID PNEUMONIA

Lipoid pneumonia in infants is most commonly due to the aspiration of milk, mineral oil, or the use of oily nose drops. There is a low incidence of lipoid pneumonia observed in developed countries, but in developing countries, lipoid pneumonia continues to represent a problem because of regional customs. We describe the cases of eight infants (aged 2 to 8 months) who developed lipoid pneumonia. Seven of the infants were fed ghee during the first month of life, and one infant was given olive oil nose drops as a nasopharyngeal cleansing agent. Progressive tachypnea developed in seven of the infants and this was associated with a dry nonproductive cough and recurrent febrile illness that required repeated hospitalization for the diagnosis and treatment of persistent bilateral pulmonary infiltrates of the dependent lung segments. Fine needle aspiration of consolidated lung tissue yielded lipid-laden macrophages and aggregates of lymphocytes and granulomas. The differential diagnosis of lipoid pneumonia must be considered in an infant who presents with a history of persistent pulmonary infiltrates primarily involving the posterior dependent lung segments, and who has a positive exposure history.