Numerous interstitial fat globules of varying size accompanied by inflammation and fibrosis is characteristic of chronic lipid pneumonia secondary to lipid aspiration.
Fire breather’s pneumonia usually presents with certain non-specific symptoms, and may vary significantly among individuals. The most common symptoms include:[5]
Acute pneumonitis typically begins asymptomatic, with a worsening of symptoms over the course of hours or days. Following aspiration of fuel, there is often a period of latency from 8–24 hours before the symptoms occur.[6] Patients may not recall a specific instance of aspiration. Severe cases may lead to acute respiratory distress syndrome (ARDS).
Causes
Fire breather’s pneumonia is caused by the entrance of hydrocarbon fuels into the bronchial tree, usually due to accidental aspiration or inhalation during a fire performance show. Fire breathing, or fire blowing, is the act of creating a plume of fire by blowing a mouthful of fuel in a fine mist (atomization) over a source of ignition. Fire eating, or fire swallowing, is the act of putting a flaming object into the mouth and extinguishing it.[7]
In both disciplines, the performer holds their breath until the air is clear of vapors, so as to not inhale the hazardous fumes. However, improper technique or an accident can lead to ingestion, inhalation, or aspiration of fine droplets or vapors. Fire breathing and fire eating are separate acts, but the terms are sometimes erroneously used interchangeably in the literature.[7]
Fuel ingestion can also occur due to siphoning by mouth of fuel products.[4]
Fire breathing is typically performed with a high flash point fuel, such as lamp oil (liquid paraffin), while fire eating is performed with low flash point fuels, such as white gas or naphtha. Highly purified fuels are preferred by fire performers due to their minimized toxicity, but other, more dangerous fuels may sometimes be used, such as ethanol, isopropanol, kerosene, gasoline, or charcoal lighter fluid. All fuels run the risk of causing pneumonitis if inhaled, however longer chain oils are more persistent than smaller molecules. Alcohols and volatile naphthas are likely to be absorbed or expelled from the body by evaporation and respiration.
Diagnosis
Exogenous lipid pneumonia is rare in the general population,[9] but occupational accidents may not be uncommon in fire performers. Diagnosis is usually made on the basis of history of exposure to hydrocarbon fuels, symptoms, and radiological findings. The radiological findings are nonspecific, and the disease presents with variable patterns and distribution. For this reason, lipoid pneumonia may mimic many other diseases, and the diagnosis is often delayed.[10]
Chest X-rays taken shortly after the accident may or may not be abnormal, but typically over time show infiltrates in the lower lobes of the lungs. High-resolution CT will frequently demonstrate abnormalities, including opacities, pleural effusion, consolidation, or pulmonary nodules.[citation needed] Histopathology of lung biopsy or bronchoalveolar lavage may indicate lipid-laden macrophages. Laboratory results may show highly elevated inflammatory markers.[11]
Treatment
The course of treatment of fire breather's pneumonia remains controversial. Administration of bronchodilators, corticosteroids, and prophylactic antibiotics to prevent secondary infection is a common course of treatment. Some studies suggest that steroids may improve outcomes in severely affected individuals, yet these data are only based on a limited number of patients. The use of gastric decontamination to prevent subsequent pulmonary injury from hydrocarbon ingestion is controversial. It may have potential benefit in large (> 30 cc), intentional ingestion of compounds with systemic toxicity.[12]
Prognosis after peak symptoms is typically good, with most patients making a full recovery in weeks to months.[4][5]
^Karacan O, Yilmaz I, Eyüboğlu FO (2006). "Fire-eater's pneumonia after aspiration of liquid paraffin". The Turkish Journal of Pediatrics. 48 (1): 85–8. PMID 16562794.
^Marchiori E, Zanetti G, Mano CM, Hochhegger B (May 2011). "Exogenous lipoid pneumonia. Clinical and radiological manifestations". Respiratory Medicine. 105 (5): 659–66. doi:10.1016/j.rmed.2010.12.001. PMID 21185165.
^Brander PE, Taskinen E, Stenius-Aarniala B (January 1992). "Fire-eater's lung". The European Respiratory Journal. 5 (1): 112–4. PMID 1577131.
^ abcAboudara M, Yun J (January 2006). "A Case of Fire-eater's Pneumonia in an Active-Duty Soldier". MedGenMed. 8 (2): 67. PMC1785213. PMID 16926806.
^ abWeinberg I, Fridlender ZG (May 2010). "Exogenous lipoid pneumonia caused by paraffin in an amateur fire breather". Occupational Medicine. 60 (3): 234–5. doi:10.1093/occmed/kqq020. PMID 20308260.
^Harding FM, Hiddinga BI, Eijsvogel MM, van Baarlen J, Oosterhof-Berktas R (2010). "[Aspiration pneumonitis after fire-eating: fire-eater's lung]". Nederlands Tijdschrift voor Geneeskunde (in Dutch). 154 (45): A2358. PMID 21118594.
^ abJoe Nickell (2005-09-09). Secrets of the Sideshows. University Press of Kentucky. pp. 209–. ISBN0-8131-2358-5.
^Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ (January 2010). "Lipoid pneumonia: spectrum of clinical and radiologic manifestations". American Journal of Roentgenology. 194 (1): 103–9. doi:10.2214/AJR.09.3040. PMID 20028911.
^Simmons A, Rouf E, Whittle J (November 2007). "Not Your Typical Pneumonia: A Case of Exogenous Lipid Pneumonia". Journal of General Internal Medicine. 22 (11): 1613–16. doi:10.1007/s11606-007-0280-7. PMC2219803. PMID 17846847.
^Shaikh AY, Oliveira PJ (February 2014). "Exogenous lipoid pneumonia (fire-eater's lung)". The American Journal of Medicine. 127 (2): e3–4. doi:10.1016/j.amjmed.2013.10.008. PMID 24332724.
^Franzen D, Kohler M (September 2012). "Severe pneumonitis after fire eating". BMJ Case Reports. 2012: bcr2012006528. doi:10.1136/bcr-2012-006528. PMC4544336. PMID 22948995.
^Nelson, Lewis (2011). Goldfrank's toxicologic emergencies. New York: McGraw-Hill Medical. ISBN9780071605939.
External links
January 07, 2023
fire, breather, pneumonia, distinct, type, exogenous, that, originating, outside, body, lipoid, pneumonia, chemical, pneumonitis, that, results, from, inhalation, aspiration, hydrocarbons, different, types, such, lamp, accidental, inhalation, hydrocarbon, fuel. Fire breather s pneumonia is a distinct type of exogenous that is originating outside the body lipoid pneumonia chemical pneumonitis that results from inhalation or aspiration of hydrocarbons of different types such as lamp oil 1 Accidental inhalation of hydrocarbon fuels can occur during fire breathing fire eating or other fire performance and may lead to pneumonitis Fire breather s pneumoniaOther namesFire breather s lung fire eater s lungNumerous interstitial fat globules of varying size accompanied by inflammation and fibrosis is characteristic of chronic lipid pneumonia secondary to lipid aspiration SpecialtyRespirologySymptoms can vary significantly among individuals ranging from asymptomatic to a severe life threatening disease 2 Onset usually occurs within hours though symptoms may not appear for several days Lipoid pneumonia is a rare condition but is an occupational hazard of fire performers 3 4 Contents 1 Signs and symptoms 2 Causes 2 1 Fuels 3 Diagnosis 4 Treatment 5 See also 6 References 7 External linksSigns and symptoms EditFire breather s pneumonia usually presents with certain non specific symptoms and may vary significantly among individuals The most common symptoms include 5 Cough Dyspnea shortness of breath Chest pain Fever Weakness Hemoptysis coughing up blood Acute pneumonitis typically begins asymptomatic with a worsening of symptoms over the course of hours or days Following aspiration of fuel there is often a period of latency from 8 24 hours before the symptoms occur 6 Patients may not recall a specific instance of aspiration Severe cases may lead to acute respiratory distress syndrome ARDS Causes EditFire breather s pneumonia is caused by the entrance of hydrocarbon fuels into the bronchial tree usually due to accidental aspiration or inhalation during a fire performance show Fire breathing or fire blowing is the act of creating a plume of fire by blowing a mouthful of fuel in a fine mist atomization over a source of ignition Fire eating or fire swallowing is the act of putting a flaming object into the mouth and extinguishing it 7 In both disciplines the performer holds their breath until the air is clear of vapors so as to not inhale the hazardous fumes However improper technique or an accident can lead to ingestion inhalation or aspiration of fine droplets or vapors Fire breathing and fire eating are separate acts but the terms are sometimes erroneously used interchangeably in the literature 7 Fuel ingestion can also occur due to siphoning by mouth of fuel products 4 Once inhaled these fuels induce an inflammatory reaction in lung tissue They are not metabolized by tissue enzymes but undergo emulsification and become engulfed by macrophages which with time may disintegrate and release oily substances surrounded by fibrous tissue and giant cells 8 Fuels Edit Fire breathing is typically performed with a high flash point fuel such as lamp oil liquid paraffin while fire eating is performed with low flash point fuels such as white gas or naphtha Highly purified fuels are preferred by fire performers due to their minimized toxicity but other more dangerous fuels may sometimes be used such as ethanol isopropanol kerosene gasoline or charcoal lighter fluid All fuels run the risk of causing pneumonitis if inhaled however longer chain oils are more persistent than smaller molecules Alcohols and volatile naphthas are likely to be absorbed or expelled from the body by evaporation and respiration Diagnosis EditExogenous lipid pneumonia is rare in the general population 9 but occupational accidents may not be uncommon in fire performers Diagnosis is usually made on the basis of history of exposure to hydrocarbon fuels symptoms and radiological findings The radiological findings are nonspecific and the disease presents with variable patterns and distribution For this reason lipoid pneumonia may mimic many other diseases and the diagnosis is often delayed 10 Chest X rays taken shortly after the accident may or may not be abnormal but typically over time show infiltrates in the lower lobes of the lungs High resolution CT will frequently demonstrate abnormalities including opacities pleural effusion consolidation or pulmonary nodules citation needed Histopathology of lung biopsy or bronchoalveolar lavage may indicate lipid laden macrophages Laboratory results may show highly elevated inflammatory markers 11 Treatment EditThe course of treatment of fire breather s pneumonia remains controversial Administration of bronchodilators corticosteroids and prophylactic antibiotics to prevent secondary infection is a common course of treatment Some studies suggest that steroids may improve outcomes in severely affected individuals yet these data are only based on a limited number of patients The use of gastric decontamination to prevent subsequent pulmonary injury from hydrocarbon ingestion is controversial It may have potential benefit in large gt 30 cc intentional ingestion of compounds with systemic toxicity 12 Prognosis after peak symptoms is typically good with most patients making a full recovery in weeks to months 4 5 See also EditFire breathing Fire eating Fire dancing Acute respiratory distress syndromeReferences Edit Karacan O Yilmaz I Eyuboglu FO 2006 Fire eater s pneumonia after aspiration of liquid paraffin The Turkish Journal of Pediatrics 48 1 85 8 PMID 16562794 Marchiori E Zanetti G Mano CM Hochhegger B May 2011 Exogenous lipoid pneumonia Clinical and radiological manifestations Respiratory Medicine 105 5 659 66 doi 10 1016 j rmed 2010 12 001 PMID 21185165 Brander PE Taskinen E Stenius Aarniala B January 1992 Fire eater s lung The European Respiratory Journal 5 1 112 4 PMID 1577131 a b c Aboudara M Yun J January 2006 A Case of Fire eater s Pneumonia in an Active Duty Soldier MedGenMed 8 2 67 PMC 1785213 PMID 16926806 a b Weinberg I Fridlender ZG May 2010 Exogenous lipoid pneumonia caused by paraffin in an amateur fire breather Occupational Medicine 60 3 234 5 doi 10 1093 occmed kqq020 PMID 20308260 Harding FM Hiddinga BI Eijsvogel MM van Baarlen J Oosterhof Berktas R 2010 Aspiration pneumonitis after fire eating fire eater s lung Nederlands Tijdschrift voor Geneeskunde in Dutch 154 45 A2358 PMID 21118594 a b Joe Nickell 2005 09 09 Secrets of the Sideshows University Press of Kentucky pp 209 ISBN 0 8131 2358 5 Betancourt SL Martinez Jimenez S Rossi SE Truong MT Carrillo J Erasmus JJ January 2010 Lipoid pneumonia spectrum of clinical and radiologic manifestations American Journal of Roentgenology 194 1 103 9 doi 10 2214 AJR 09 3040 PMID 20028911 Simmons A Rouf E Whittle J November 2007 Not Your Typical Pneumonia A Case of Exogenous Lipid Pneumonia Journal of General Internal Medicine 22 11 1613 16 doi 10 1007 s11606 007 0280 7 PMC 2219803 PMID 17846847 Shaikh AY Oliveira PJ February 2014 Exogenous lipoid pneumonia fire eater s lung The American Journal of Medicine 127 2 e3 4 doi 10 1016 j amjmed 2013 10 008 PMID 24332724 Franzen D Kohler M September 2012 Severe pneumonitis after fire eating BMJ Case Reports 2012 bcr2012006528 doi 10 1136 bcr 2012 006528 PMC 4544336 PMID 22948995 Nelson Lewis 2011 Goldfrank s toxicologic emergencies New York McGraw Hill Medical ISBN 9780071605939 External links Edit Retrieved from https en wikipedia org w index php title Fire breather 27s pneumonia amp oldid 1094751568, wikipedia, wiki, book, books, library,
