Chemical pneumonitis

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Chemical pneumonitis
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Chemical pneumonitis is inflammation of the lung caused by aspirating or inhaling irritants. [1] It is sometimes called a "chemical pneumonia", though it is not infectious. There are two general types of chemical pneumonitis: acute and chronic.

Contents

Irritants capable of causing chemical pneumonitis include vomitus, [2] barium used in gastro-intestinal imaging, chlorine gas (among other pulmonary agents), [2] ingested gasoline [2] or other petroleum distillates, ingested or skin absorbed pesticides, [2] gases from electroplating, [2] smoke [2] and others. It may also be caused by the use of inhalants. Mendelson's syndrome is a type of chemical pneumonitis.

Mineral oil should not be given internally to young children, pets, or anyone with a cough, hiatal hernia, or nocturnal reflux, because it can cause complications such as lipoid pneumonia. [3] Due to its low density, it is easily aspirated into the lungs, where it cannot be removed by the body. In children, if aspirated, the oil can work to prevent normal breathing, resulting in death of brain cells and permanent paralysis and/or brain damage.

Signs and symptoms

Acute:

Chronic:

Symptoms of chronic chemical pneumonitis may or may not be present, and can take months or years to develop to the point of noticeability. [4]

Diagnosis

The pragmatic challenge is to distinguish from aspiration pneumonia with an infectious component because the former does not require antibiotics while the latter does. While some issues, such as a recent history of exposure to substantive toxins, can foretell the diagnosis, for a patient with dysphagia the diagnosis may be less obvious, as the dysphagic patient may have caustic gastric contents damaging the lungs which may or may not have progressed to bacterial infection. [5]

The following tests help determine how severely the lungs are affected:

Treatment

Treatment is focused on reversing the cause of inflammation and reducing symptoms. Corticosteroids may be given to reduce inflammation, often before long-term scarring occurs. Antibiotics are usually not helpful or needed, unless there is a secondary infection. Oxygen therapy may be helpful.

Related Research Articles

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<span class="mw-page-title-main">Cough</span> Sudden expulsion of air from the lungs as a reflex to clear irritants

A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.

<span class="mw-page-title-main">Pleurisy</span> Disease of the lungs

Pleurisy, also known as pleuritis, is inflammation of the membranes that surround the lungs and line the chest cavity (pleurae). This can result in a sharp chest pain while breathing. Occasionally the pain may be a constant dull ache. Other symptoms may include shortness of breath, cough, fever, or weight loss, depending on the underlying cause. Pleurisy can be caused by a variety of conditions, including viral or bacterial infections, autoimmune disorders, and pulmonary embolism.

<span class="mw-page-title-main">Pulmonary aspiration</span> Entry of materials into the larynx (voice box) and lower respiratory tract

Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx and lower respiratory tract, the portions of the respiratory system from the trachea (windpipe) to the lungs. A person may inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe".

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<span class="mw-page-title-main">Atelectasis</span> Collapse or closure of a lung resulting in reduced or absent gas exchange

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<span class="mw-page-title-main">Interstitial lung disease</span> Group of diseases

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<span class="mw-page-title-main">Aspiration pneumonia</span> Medical condition

Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs. Signs and symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess, acute respiratory distress syndrome, empyema, and parapneumonic effusion. Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs.

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Post-nasal drip (PND), also known as upper airway cough syndrome (UACS), occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the back of the nose, and eventually in the throat once it drips down the back of the throat. It can be caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing. Other causes can be allergy, cold, flu, and side effects from medications.

<span class="mw-page-title-main">Hypersensitivity pneumonitis</span> Medical condition

Hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis (EAA) is a syndrome caused by the repetitive inhalation of antigens from the environment in susceptible or sensitized people. Common antigens include molds, bacteria, bird droppings, bird feathers, agricultural dusts, bioaerosols and chemicals from paints or plastics. People affected by this type of lung inflammation (pneumonitis) are commonly exposed to the antigens by their occupations, hobbies, the environment and animals. The inhaled antigens produce a hypersensitivity immune reaction causing inflammation of the airspaces (alveoli) and small airways (bronchioles) within the lung. Hypersensitivity pneumonitis may eventually lead to interstitial lung disease.

<span class="mw-page-title-main">Lung abscess</span> Medical condition

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<span class="mw-page-title-main">Pneumonitis</span> General inflammation of lung tissue

Pneumonitis describes general inflammation of lung tissue. Possible causative agents include radiation therapy of the chest, exposure to medications used during chemo-therapy, the inhalation of debris, aspiration, herbicides or fluorocarbons and some systemic diseases. If unresolved, continued inflammation can result in irreparable damage such as pulmonary fibrosis.

<span class="mw-page-title-main">Respiratory disease</span> Disease of the respiratory system

Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bronchioles, alveoli, pleurae, pleural cavity, the nerves and muscles of respiration. Respiratory diseases range from mild and self-limiting, such as the common cold, influenza, and pharyngitis to life-threatening diseases such as bacterial pneumonia, pulmonary embolism, tuberculosis, acute asthma, lung cancer, and severe acute respiratory syndromes, such as COVID-19. Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause of the disease.

<span class="mw-page-title-main">Bronchiolitis obliterans</span> Medical condition

Bronchiolitis obliterans (BO), also known as obliterative bronchiolitis, constrictive bronchiolitis and popcorn lung, is a disease that results in obstruction of the smallest airways of the lungs (bronchioles) due to inflammation. Symptoms include a dry cough, shortness of breath, wheezing and feeling tired. These symptoms generally get worse over weeks to months. It is not related to cryptogenic organizing pneumonia, previously known as bronchiolitis obliterans organizing pneumonia.

<span class="mw-page-title-main">Farmer's lung</span> Hypersensitivity pneumonitis

Farmer's lung is a hypersensitivity pneumonitis induced by the inhalation of biologic dusts coming from hay dust or mold spores or any other agricultural products. It results in a type III hypersensitivity inflammatory response and can progress to become a chronic condition which is considered potentially dangerous.

Occupational lung diseases are work-related, lung conditions that have been caused or made worse by the materials a person is exposed to within the workplace. It includes a broad group of diseases, including occupational asthma, industrial bronchitis, chronic obstructive pulmonary disease (COPD), bronchiolitis obliterans, inhalation injury, interstitial lung diseases, infections, lung cancer and mesothelioma. These diseases can be caused directly or due to immunological response to an exposure to a variety of dusts, chemicals, proteins or organisms.

<span class="mw-page-title-main">Classification of pneumonia</span> Medical condition

Pneumonia can be classified in several ways, most commonly by where it was acquired, but may also by the area of lung affected or by the causative organism. There is also a combined clinical classification, which combines factors such as age, risk factors for certain microorganisms, the presence of underlying lung disease or systemic disease and whether the person has recently been hospitalized.

<span class="mw-page-title-main">Fire breather's pneumonia</span> Medical condition

Fire breather's pneumonia is a distinct type of exogenous—that is, originating outside the body—lipoid pneumonia that results from inhalation or aspiration of hydrocarbons of different types, such as lamp oil. Accidental inhalation of hydrocarbon fuels can occur during fire breathing, fire eating, or other fire performance, and may lead to pneumonitis.

Hydrocarbon pneumonitis is a kind of chemical pneumonitis which occurs with oral ingestion of hydrocarbons and associated aspiration. It occurs prominently among children, accounting for many hospital admissions each year. Common hydrocarbons involved are mineral spirits, mineral seal oil, lamp oil, kerosene (paraffin), turpentine, gasoline, and lighter fluid. Pneumatocele is a complication of hydrocarbon pneumonitis. In both childhood and adult pneumonitis, hydrocarbon aspiration occurs at the time of initial ingestion event or subsequently with vomiting. Low viscosity of an ingested hydrocarbon is considered a major factor promoting aspiration. Contrary to aspiration hydrocarbon pneumonitis, hydrocarbon (solvent) vapor inhalation manifests primarily in either central nervous system or cardiac effects.

Chronic cough is long-term coughing, sometimes defined as more than several weeks or months. The term can be used to describe the different causes related to coughing, the three main ones being upper airway cough syndrome, asthma and gastroesophageal reflux disease. It occurs in the upper airway of the respiratory system. Generally, a cough lasts around one to two weeks; however, chronic cough can persist for an extended period of time defined as six weeks or longer. People with chronic cough often experience more than one cause present. Due to the nature of the syndrome, the treatments used are similar; however, there are a subsequent number of treatments available, and the clinical management of the patients remains a challenge.

References

  1. Marik, PE (May 2011). "Pulmonary aspiration syndromes". Current Opinion in Pulmonary Medicine. 17 (3): 148–54. doi:10.1097/MCP.0b013e32834397d6. PMID   21311332. S2CID   31735383.
  2. 1 2 3 4 5 6 7 8 9 Stitham, Sean et al. "Chemical Pneumonitis: Medline Plus Medical Encyclopedia", Medline Plus, 2008-8-29. Retrieved on 2009-10-06.
  3. "Call For Change To Mineral Oil Label" Archived October 12, 2007, at the Wayback Machine PersonalMD, 1998-12-28. Retrieved on 2009-10-06
  4. 1 2 3 4 5 "Chemical Pneumonitis: Causes, Symptoms" PDRHealth. Retrieved on 2009-10-06
  5. Taylor, G (1975). "Acid Pulmonary Aspiration Syndrome After Antacids". British Journal of Anaesthesiology. 47 (5): 615–617. doi: 10.1093/bja/47.5.615 . PMID   237522.