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Introduction <p>Lipoid pneumonia (LP), a rare lung injury caused by lipid aspiration, lacks standardized treatments. Diesel exposure poses significant risks due to hydrocarbon toxicity, often progressing to severe pneumonitis. We present a case of diesel-induced LP refractory to conventional therapy, successfully treated with polysorbate 80 lung lavage.</p> Case Presentation <p>A 46-year-old male with diesel tank immersion history presented with dyspnea, low peripheral oxygen saturation (SpO₂ 88% on room air), and fever 1-month post-exposure. Imaging revealed right lower lobe consolidation; bronchoscopy identified lipid-laden macrophages. Despite 14&#xa0;days of antibiotics, corticosteroids, and oxygen therapy, his SpO₂ worsened to 84% on room air. Segmental lung lavage using 150&#xa0;mL of 0.1% polysorbate 80 in Ringer’s lactate was performed. Within days, oxygen saturation improved to 95%, inflammatory markers normalized (CRP: 117 → 4&#xa0;mg/dL), and imaging showed near-complete resolution. The patient was discharged on day 35 without complications.</p> Conclusions <p>Polysorbate 80 lavage effectively resolved diesel-induced LP in this steroid-refractory case, likely by emulsifying and removing alveolar lipids. This approach warrants further investigation as a therapeutic option for severe hydrocarbon pneumonitis. Multicenter studies are needed to establish safety, dosing, and long-term outcomes. </p>

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Successful Treatment of Severe Hydrocarbon Pneumonitis with Polysorbate 80 Lung Lavage: A Case Report

  • 期刊论文

  • 发表日期：

    2025年7月22日

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  • Sanaz Asadi,
  • Ghazal Roostaei,
  • Hossein Kazemizadeh,
  • Niloofar Khoshnam Rad,
  • Behnaz Jahanbin,
  • Hamidreza Abtahi,
  • Shahram Firouzbakhsh,
  • Mahsa Yousefi Mokri

摘要

Introduction

Lipoid pneumonia (LP), a rare lung injury caused by lipid aspiration, lacks standardized treatments. Diesel exposure poses significant risks due to hydrocarbon toxicity, often progressing to severe pneumonitis. We present a case of diesel-induced LP refractory to conventional therapy, successfully treated with polysorbate 80 lung lavage.

Case Presentation

A 46-year-old male with diesel tank immersion history presented with dyspnea, low peripheral oxygen saturation (SpO₂ 88% on room air), and fever 1-month post-exposure. Imaging revealed right lower lobe consolidation; bronchoscopy identified lipid-laden macrophages. Despite 14 days of antibiotics, corticosteroids, and oxygen therapy, his SpO₂ worsened to 84% on room air. Segmental lung lavage using 150 mL of 0.1% polysorbate 80 in Ringer’s lactate was performed. Within days, oxygen saturation improved to 95%, inflammatory markers normalized (CRP: 117 → 4 mg/dL), and imaging showed near-complete resolution. The patient was discharged on day 35 without complications.

Conclusions

Polysorbate 80 lavage effectively resolved diesel-induced LP in this steroid-refractory case, likely by emulsifying and removing alveolar lipids. This approach warrants further investigation as a therapeutic option for severe hydrocarbon pneumonitis. Multicenter studies are needed to establish safety, dosing, and long-term outcomes.