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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006528
  • Reminder of important clinical lesson

Severe pneumonitis after fire eating

  1. Malcolm Kohler2
  1. 1Department of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
  2. 2Department of Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland
  1. Correspondence to Dr Daniel Franzen, daniel.franzen{at}usz.ch

Summary

A 38-year-old, previously healthy fire eater presented with severe pneumonitis after incidental aspiration of an unquantifiable amount of petroleum. The chest CT revealed extensive pulmonary consolidations, and the laboratory results showed massively elevated inflammatory markers. An intravenous antibiotic treatment was started and, after improvement of symptoms and inflammatory markers, continued orally for a total of 3 weeks, despite negative results of blood cultures and urinary pneumococcal and legionella antigen tests. The patient's symptoms subsided completely, and a CT scan 10 weeks after the accident showed complete resolution of the lung consolidations. Aspiration of petroleum is associated with a severe inflammatory response of the lung, but if bacterial superinfection can be prevented with early antibiotic treatment, even a severe presentation of a fire eater's lung usually follows a benign course with complete recovery.

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