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Case Series
Three cases of virgin coconut oil-induced lipoid pneumonia in infants
1 Consultant, Pediatric Pulmonology, St. Luke’s Medical Center, QC and BGC, Philippines
2 Consultant, Pediatric Pulmonology, St. Luke’s Medical Center, QC, Philippines
3 Consultant, Radiology, St. Luke’s Medical Center, QC and BGC, Philippines
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Maria Isabel M Atienza
MD, MHPEd, Consultant, Pediatric Pulmonology, St. Luke’s Medical Center, QC,
Philippines
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Article ID: 100008Z19MA2020
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Atienza MIM, Afable GER, Concepcion NDP. Three cases of virgin coconut oil-induced lipoid pneumonia in infants. J Case Rep Images Pediatr 2020;2:100008Z19MA2020.ABSTRACT
Introduction: Three cases of lipoid pneumonia in infancy are presented to highlight the risk factors, clinical features, diagnostic and therapeutic measures of this rare and serious type of pneumonia.
Case Series: The three infants were admitted at a tertiary hospital for pneumonia after having received treatment with supplemental virgin coconut oil (VCO) treatment for poor weight gain. All cases presented with tachypnea and clear breath sounds, while only case #3 presented with fever. All three admissions resulted in a battery of diagnostic tests. Computed tomography (CT) scans of the chest demonstrated the typical features of lipoid pneumonia showing air-space consolidation with areas of low attenuation having negative Hounsfield unit (HU). Fiberoptic bronchoscopy with bronchoalveolar lavage allowed the documentation of the presence of residual oil in the affected lungs. All three were generally unresponsive to empiric intravenous antibiotics.
Conclusion: The potential benefits of oral coconut oil are minimal and the risk of oil aspiration results in a complicated form of pneumonia. The oral administration of coconut oil should be avoided in infants who have had low birth weight and poor weight gain even on pure breastfeeding. An immediate chest CT scan and bronchoscopy with bronchoalveolar lavage must be done in all cases with a high index of suspicion of coconut oil-induced lipoid pneumonia. The three cases have demonstrated that lipoid pneumonia in infants is complicated by the presence of atypical infectious agents, transient immunodeficiency, and prolonged hospitalization. Furthermore, there is the great need for continuous home treatment with antibiotics and supplemental oxygen inhalation.
Keywords: Bronchoalveolar lavage, Coconut oil, Foamy macrophages, Lipoid pneumonia
SUPPORTING INFORMATION
Author Contributions
Maria Isabel M Atienza - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Gerarda Ember R Afable - Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Nathan David P Concepcion - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Maria Isabel M Atienza et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
