Exogenous lipoid pneumonia caused by Nigella sativa oil – A case report

AbstractIntroductionExogenous lipoid pneumonia (ELP) is an uncommon and chronic infiltrative pulmonary process secondary to continued aspiration of exogenous lipids.Nigella sativa, or the black cumin seed, is a herb used in traditional medicine in many Middle Eastern and Asian countries to treat a broad array of diseases.ObjectiveThe purpose of the present case report is to reveal the role of the abuse of N. sativa seed oil (black cumin seed oil), as an exceptional cause of ELP, which has not been, to our knowledge, previously documented.Case reportA 50-year-old man was evaluated for a 6-month history of cough, sputum and progressively worsening dyspnea on exertion.His medical history included long-term smoking. We questioned the patient specifically about use of any traditional herbal medicinal products. He acknowledged that he had been taking one tablespoon (15ml) of N. sativa oil at bedtime since 8months (8 bottles of 500ml) for the purposes of tonification. Exogenous lipid pneumonia was suspected.Physical examination found bilateral crackles of the lung bases. Lung function tests were normal. The chest radiograph showed thoracic distension and bilateral basal interstitial disease. Computed tomography (CT) of the chest was performed, and revealed infiltrative lung disease affecting the posterobasal segments of the right and left lower lobes, honeycomb fibrosis was seen at the bases of both lungs. Routine blood tests were normal. Sputum and blood culture were sterile.We performed bronchoscopy with transbronchial biopsies and bronchoalveolar lavage. The color of the lavage liquid was blakish with fat globules on the fluid surface. It contained 220,000cells/ml. Differential cell count showed 87% macrophages, 13% lymphocytes; stains and cultures for infectious agents were negative.The patient was advised to stop taking N. sativa oil. The only treatment that was instituted was N-acetylcysteine. A clinically significant change in symptoms and chest radiograph was observed. The patient has remained stable 18months after the diagnosis

Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest

OBJECTIVE: To present the findings of computed tomography (CT) scans of the chest in patients with laryngotracheobronchial papillomatosis. METHODS: We retrospectively analyzed CT scans of eight patients, five males and three females, ranging from 5 to 18 years of age with a mean age of 10.5 years. Images were independently reviewed by two radiologists. In discrepant cases, a consensus was reached. RESULTS: The most common CT findings were intratracheal polypoid lesions and pulmonary nodules, many of which were cavitated. CONCLUSIONS: In patients with laryngotracheobronchial papillomatosis, the most common tomographic finding was the combination of intratracheal polypoid lesions and multiple pulmonary nodules, many of which were cavitated.OBJETIVO: Apresentar os achados em tomografia computadorizada (TC) de tórax em pacientes com papilomatose laringotraqueobrônquica. MÉTODOS: Foram estudadas, retrospectivamente, as TCs de oito pacientes, cinco masculinos e três femininos, com idades variando de 5 a 18 anos, com média de 10,5 anos. Os exames foram analisados por dois radiologistas, de forma independente, e as decisões finais foram obtidas por consenso. RESULTADOS: Os achados mais comuns nas TCs foram as lesões nodulares da traquéia e os nódulos pulmonares, muitos com escavação. CONCLUSÕES: O aspecto tomográfico mais freqüentemente observado nos casos de papilomatose laringotraqueobrônquica foi a associação de lesões polipóides de traquéia com múltiplos nódulos pulmonares, vários deles escavados.Universidade Federal Fluminense Departamento de RadiologiaUniversidade Federal da BahiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnóstico por ImagemBroadgreen University Hospitals Royal LiverpoolFaculdade de Medicina de PetrópolisUniversidade Federal de São Paulo (UNIFESP) Departamento de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoUNIFESP, EPM, Depto. de Diagnóstico por ImagemUNIFESP, Depto. de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoSciEL

COVID-19 - Computed tomography findings in two patients in Petrópolis, Rio de Janeiro, Brazil

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