石蜡油误吸致儿童外源性类脂性肺炎一例

A Case Report of Exogenous Lipoid Pneumonia in a Child Secondary to Paraffin Oil Aspiration

摘要: 目的：本研究旨在探讨儿童外源性类脂性肺炎这一罕见病例的临床特征，强调详细病史询问、早期诊断和及时治疗对改善预后的重要性。方法：对湘西自治州人民医院儿童医学中心PICU收治的1例外源性类脂性肺炎患儿进行病例分析，通过记录其临床特点、影像学表现、支气管肺泡灌洗液(BAL)结果，以及治疗方案和转归情况进行探讨。结果：患儿，男，4月龄，因重症肺炎入PICU，病史追问得知有多次石蜡油误吸史，确诊为外源性类脂性肺炎。经过支气管肺泡灌洗、激素及丙种球蛋白治疗后，患者临床症状改善，肺部影像学显示明显好转，并顺利出院。结论：儿童外源性类脂性肺炎临床罕见，详细的病史采集对该病的诊断尤为关键。针对本病例采用的支气管肺泡灌洗联合糖皮质激素、丙种球蛋白的治疗方案，可有效改善临床症状，为该类疾病的临床治疗提供了单病例实践参考，后续仍需通过长期随访完善患儿预后数据，为疾病诊疗积累更多临床依据。

Abstract: Objective: This study aims to explore the clinical characteristics of exogenous lipoid pneumonia (ELP), a rare condition in children, and emphasize the importance of detailed medical history, early diagnosis, and timely intervention in improving prognosis. Methods: A case analysis was performed on a child with ELP admitted to the Pediatric Intensive Care Unit (PICU) of the Children’s Medical Center at Xiangxi Tujia and Miao Autonomous Prefecture People’s Hospital. Clinical features, imaging findings, bronchoalveolar lavage (BAL) fluid analysis, treatment strategies, and outcomes were systematically documented and analyzed. Results: A 4-month-old male patient was admitted to the PICU with severe pneumonia. Further history-taking revealed multiple episodes of paraffin oil aspiration, leading to a confirmed diagnosis of ELP. Following treatment with bronchoalveolar lavage, corticosteroids, and intravenous immunoglobulin (IVIG), the patient’s clinical symptoms significantly improved, with marked resolution of pulmonary imaging abnormalities. The child was discharged in stable condition. Conclusion: Exogenous lipoid pneumonia is rare in children, with thorough history-taking critical for its diagnosis. In this case, bronchoalveolar lavage (BAL) combined with glucocorticoids and intravenous immunoglobulin (IVIG) effectively improved clinical symptoms, providing a single-case reference for treating this condition. Long-term follow-up is warranted to refine this patient’s prognostic data and accumulate more clinical evidence for the diagnosis and management of this disease.