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Acute inhalation lung injury secondary to zinc and copper aspiration from food contact dust
  1. James Moss1,2,
  2. Aditi Sinha3,
  3. Shrouk Messahel4 and
  4. Christopher Grime3
  1. 1Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
  2. 2NIHR Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  3. 3Respiratory Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  4. 4Emergency Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr James Moss; james.moss{at}


A previously healthy boy of preschool age was brought to the emergency department by ambulance with respiratory distress following the accidental inhalation of food contact dust (cake decorating powder). Prehospital oxygen saturations were 80% in room air. Initial treatment was with oxygen, nebulised salbutamol, oral dexamethasone and intravenous amoxicillin/clavulanic acid. Treatment was escalated to nasal high flow oxygen therapy and high dependency care within 8 hours. Lung fields on his initial chest X-ray were clear but the following day showed perihilar infiltrates extending into the lower zones in keeping with inflammation. He was treated with intravenous methylprednisolone, followed by a weaning dose of oral prednisolone over 14 days.

He required oxygen therapy for 9 days and remained in hospital for 11 days. Outpatient follow-up, 24 days after the inhalation took place was reassuring with the child showing no signs of abnormal respiratory symptoms.

  • Paediatrics
  • Respiratory medicine
  • Emergency medicine
  • Unwanted effects / adverse reactions

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  • Contributors JM, AS, SM and CG were all part of the clinical team caring for the patient. All authors contributed to writing of the manuscript. The parent’s perspective is also included within the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The perspective received is from the patient's mother's.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.