Pneumonia lipídica em um lactente / Lipid pneumonia in an infant

RESUMO

Lactente de seis meses apresentava pneumonia refratária a diferentes antimicrobianos previamente utilizados. Houve melhora clínica, mas havia persistência de lesão pulmonar no radiograma de tórax. Obteve-se a informação do uso prévio de óleo mineral devido à constipação eventual. Realizou-se broncoscopia, lavado bronquíolo-alveolar e exame anatomopatológico definindo o diagnóstico como Pneumonia Lipídica. A pneumonia lipídica deverá sempre ser considerada no diagnóstico diferencial de pneumonia de evolução prolongada sem resposta ao tratamento com antimicrobianos para germes comuns e naquelescasos suspeitos de tuberculose. É importante que os pais sejam orientados sobre o uso de óleo mineral em lactentes e crianças previamente constipadas, devido ao risco de aspiração e posterior pneumonia.

ABSTRACT

A six-month old infant had pneumonia and a resistance to previously-used antimicrobials. There was clinical improvement, but a radiogram discovered a persistent pulmonary lesion in the chest. We discovered a previous use of mineral oil to combat a bout of suspected constipation. This revelation led us to performing a bronchoscopy, a bronchoalveolar lavage-alveolar procedure,and other pathological examinations, all of which led us to conclude that the condition was a form of lipid pneumonia. Thus, lipid pneumonia should always be considered in the differential diagnosis of prolonged evolving pneumonia when not responding to treatment with antimicrobials for common germs. It should also be considered in those cases of suspected tuberculosis. Because of the risk of aspiration and subsequent pneumonia, it is important that parents with infants and children be instructed on the use of mineral oil when addressingconstipation in their offspring.