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The Drug-Induced Respiratory Disease Website and App

Hydrocarbons (petrochemicals: petroleum, petrolatum, paraffin, vaseline, naphta, jet fuel (kerosene), Diesel, gasoil), ointments, salad oil, variegated oils, butter). Aspirated

Liquid (fluid) hydrocarbons or hydrocarbon mist (salad oil, paraffin, vaseline, parpetroleum, petrolatum, lamp oil, kerdane, jet fuel, kerosene, turpentine, Diesel fuel, Jet-A fuel, JP-8; paint thinner, furniture polish, bath oils or ointments (PMID 24911841, 25868376, 26063683), shark oil, butter). Pneumonitis from these chemicals/fuels and compounds is a disease of fire-eaters, or it may follow siphoning and unintentional aspiration of gasoline, Diesel or other liquid fuels in children or in adults (PMID 30581584). Therapeutic BAL has been used in some instances. Fluid hydrocarbons can cause an acute inflammatory pneumopathy w/wo chest pain, pleural effusion, cavitaion, pneumatoceles, pneumothorax, pneumomediastinum and secondary infection. Acute mortality is about 1%. Recovery is in weeks or months. Suggestive changes on pathology may wane with time (PMID 30581584). Although sometimes effective, corticosteroid therapy is associated with unpredictable results.

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.b

Pneumonitis (interstitial lung disease/ILD)
I.g

Pulmonary fibrosis
I.j

Exogenous lipoid pneumonia (subacute, acute)
I.z

An area or areas of consolidation
I.ae

Hydrocarbon pneumonitis
I.af

Chemical (toxic) pneumonitis
I.ag

Fire-eater's lung/pneumonitis

II - Pulmonary edema - Acute lung injury - ARDS

II.b

ARDS - Acute lung injury

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)
III.c

Hemoptysis

IV - Airway involvement

IV.k

Bronchiectasis

V - Pleural and/or pericardial involvement

V.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement

VIII.d

Thermal (burns, frostbite), chemical or caustic injury on the face, mouth, tongue, pharynx or upper airway

XI - Miscellaneous

XI.b

Chest pain (acute or subacute), lone or prominent
XI.s

Sniffing death - Death from inhalation of compound

XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)

XIV.a

Methemoglobinemia

XV - Pathology

XV.as

Path: Fire eater's lung

XVI - Imaging

XVI.b

Imaging: Ground-glass opacities (GGO) / shadowing
XVI.f

Imaging: Bibasilar opacities/shadowing
XVI.k

Imaging: An area or areas of consolidation
XVI.ab

Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)
XVI.ah

Imaging: Pneumatoceles (see also XVIaf)
XVI.cb

Imaging: Pneumatocele or pneumatoceles

XVII - Infections & related conditions

XVII.p

Lung abscess/abscesses (see also VIr)

XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA

XIX.a

BAL: An excess proportion of lymphocytes
XIX.h

BAL: Exogenous (oil red O-stainable) lipids in BAL macrophages