RESUMO
BACKGROUND: Lung disease due to aspiration is often unsuspected and represents a diagnostic challenge. CASE REPORT: We report on a 23-year-old male patient with cough, fever and infiltrates on the chest radiograph. The lung biopsy showed granulomatous changes consistent with tuberculosis. The surgical lung biopsy revealed aspiration bronchiolitis with necrosis, granulomatous changes and particulate foreign material. RESULTS: The aspirated matter could be identified only after repeated interrogation specifically directed to the matter. The patient had aspirated Lycopodium spores in the course of occasional fire-breathing. CONCLUSIONS: This is the first report on pulmonary disease due to aspiration of Lycopodium spores in the course of fire-breathing. It shows that the anamnesis is as crucial as histology for the definitive diagnosis of aspiration disease.