Lipoid pneumonia, or lipid pneumonia, is a rare condition that occurs when oil or fat enters the lungs. Lipoid means relating to fat. Lipoid pneumonia symptoms can include a cough, high fever, and shortness of breath.

Lipoid pneumonia can be difficult to diagnose because the symptoms are nonspecific and are similar to those of more common forms of pneumonia.

Resting and taking medication at home will be sufficient to treat some cases of lipoid pneumonia, but severe cases may require hospital treatment. Doctors treat most cases of lipoid pneumonia with corticosteroids, which reduce inflammation in the lungs.

Keep reading to learn more about lipoid pneumonia, including the causes, symptoms, and treatment.

a man coughing because he has lipoid pneumoniaShare on Pinterest
A person with lipoid pneumonia may experience a persistent cough.

Pneumonia is a serious lung disease. The cause of most cases of pneumonia is a bacterial, viral, or fungal infection, which causes swelling in the air sacs of the lungs.

However, the cause of lipoid pneumonia is fat, which enters the lungs, causing symptoms similar to those of other forms of pneumonia.

Unless a bacterial infection is also present, antibiotics will not be effective in treating lipoid pneumonia. Doctors typically use corticosteroids to treat the disease instead. The immune system fights the disease and creates inflammation in the lungs. Corticosteroids work by suppressing the immune system to reduce inflammation.

Lipoid pneumonia is the body’s reaction to fat in the air sacs of the lungs. The air sacs become inflamed, which causes them to fill with fluid. Inflammation makes it harder to breathe.

There are two forms of lipoid pneumonia: exogenous and endogenous. An exogenous case of pneumonia is one that has an external cause, while an endogenous case has an internal cause.

Exogenous lipoid pneumonia

Exogenous lipoid pneumonia occurs when fat particles enter the lungs from outside the body. Fat usually gets into the body via the mouth or nose.

Causes of exogenous lipoid pneumonia include:

E-cigarettes

In 2019, the Centers for Disease Control and Prevention (CDC) reported on five people who developed lipoid pneumonia after using e-cigarettes. The e-cigarettes contained marijuana oil. The individuals had inhaled the oil into the lungs, and it led to lipoid pneumonia.

Breathing in oil-based products

Breathing in oil-based products is another cause of exogenous lipoid pneumonia. Oil-based products in the workplace are a health risk if a person inhales them. Using a face mask and ensuring that the working area remains well-ventilated can reduce the risk.

Oil pulling

Oil pulling is a practice in alternative medicine. A person swills oil in the mouth with the aim of improving dental health. There is little evidence for the benefits of oil pulling. A 2015 study found that oil pulling was the cause of two cases of lipoid pneumonia. Some of the oil entered the lungs and led to inflammation.

Other causes

Most cases of the disease have a link to specific products or actions. A 2013 study reported on a woman who presented with lipoid pneumonia after applying baby oil to the inside of her nose for several years.

A 2012 study found that a fire-eater had developed the disease after breathing in liquid paraffin.

Endogenous lipoid pneumonia

Endogenous lipoid pneumonia, also called cholesterol pneumonia, is less common than exogenous lipoid pneumonia. It develops when fat from the body builds up in the lungs.

This fat may show up as a nodule when a person has a CT scan. By removing and examining the nodule, a doctor can diagnose lipoid pneumonia.

The cause is likely to be a blockage in the lungs that results in inflammation, leading the body to make too much cholesterol in response. The cholesterol breaks down and builds up in air sacs in the lungs.

The symptoms of lipoid pneumonia are similar to those of more common forms of pneumonia. They include:

  • a persistent cough
  • shivering
  • chest pain
  • shortness of breath
  • fever

In people who develop lipoid pneumonia after using e-cigarettes, symptoms may also include vomiting, nausea, and stomach pains.

The disease may progress slowly as fat builds up in the lungs. A person may experience difficulty breathing before other symptoms develop.

Lipoid pneumonia is difficult to diagnose because the symptoms are similar to those of other forms of pneumonia. For this reason, it is easy to miss completely or to diagnose incorrectly.

A person may not get a correct diagnosis until treatment starts. Scans or surgery can reveal inflammation or particles of fat in the lungs.

Doctors often use a CT scan to diagnose any serious lung condition. It uses X-rays to see inside the lungs and give a picture.

It is possible to misdiagnose endogenous lipoid pneumonia as lung cancer. The accumulation of fat in the lungs can appear as a cyst or nodule on a CT scan.

A doctor may need more information about lifestyle factors or recent behavior to make a diagnosis. If a person has breathed oil into the lungs, this may be the cause of pneumonia.

People with certain underlying health conditions may have a higher risk of endogenous lipoid pneumonia.

For example, researchers have suggested that Hodgkin lymphoma and rheumatoid arthritis have links to the disease.

Information about existing medical conditions may, therefore, help a doctor diagnose lipoid pneumonia.

If a person has an underlying health condition, pneumonia can be more serious. The person may need treatment in the hospital.

As lipoid pneumonia is so rare, there are no agreed guidelines for treatment. Most treatment includes corticosteroids to reduce inflammation. In some cases, a person can develop a lung infection. The most common treatment for this is antibiotics.

Doctors have used whole lung lavage — a method of physically removing fat from the lungs — to treat lipoid pneumonia. The procedure uses a general anesthetic and involves repeatedly rinsing out the lungs with a sterile saline solution. The process is complete when saline comes out of the lung clear and free of fat particles.

A person must usually receive treatment on one lung at a time, with at least 2 weeks between the treatments. This waiting period gives the first lung time to heal, which helps with breathing during the treatment of the second lung.

Once they are able to leave the hospital, a person can recover at home. They will usually need to continue taking medication, often corticosteroids. Rest is important to recover fully from pneumonia.

Pneumonia can be serious, particularly for older adults or people with underlying health conditions. The disease can have complications, such as lung abscesses or pleurisy.

Getting plenty of rest will help a person recover. Some people will feel better in a week, but for others, it can take longer. Most people should recover from pneumonia within a month, but some may continue to feel tired after the symptoms have gone away.

Lipoid pneumonia is a rare disease with a limited body of research. As a result, there is little information on how many people get the disease and recover. However, those in the case studies that we discussed above all recovered from the disease after treatment in the hospital.

Lipoid pneumonia is a very rare condition, and there are two main types.

Most cases have a link to exposure to oil or oil-based products. This exposure may be in the workplace, or it might occur due to using oils in the nose or mouth. Using e-cigarettes with flavored oils may pose some risk.

The severity of the symptoms varies among individuals, but people with severe symptoms usually require treatment in the hospital. Although there are no agreed guidelines for treatment, corticosteroids are generally effective.

Most case studies on people with lipoid pneumonia have reported that they made a full recovery from it.