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February 1994

Radiological Cases of the Month

Arch Pediatr Adolesc Med. 1994;148(2):205-206. doi:10.1001/archpedi.1994.02170020091016

Denouement and Discussion 

Lipoid Pneumonia From Mineral Oil Aspiration  A 4-month-old girl was referred for diagnostic evaluation of persistent respiratory distress and hypoxemia. She was well until age 2 months when she developed "congestion" and a "rattling" cough. She was initially treated with oral erythromycin, but slowly deteriorated with progressive respiratory distress and fever. Medical history revealed that at age 2 weeks, the patient had developed constipation. This symptom was treated successfully with oral administration of mineral oil for 10 days.The results of the physical examination revealed a pale, well-developed 4-month-old girl in mild respiratory distress. There were diffuse inspiratory crackles and occasional expiratory wheezing on chest auscultation.The pulse oximetry result in room air was 88%. Chest roentgenography was performed (Figure 1). Pertinent laboratory findings were as follows: complete blood cell count, 31.5×106; a differential cell count of 70 segmental forms; hemoglobin, 93 g/L; hematocrit, 0.28; and platelet count,