{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:55:06Z","timestamp":1776142506573,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral siphoning of diesel fuel carries substantial risks of chemical inhalation injury; however, documented cases of diesel aspiration pneumonia, especially at altitudes &amp;gt;2,500\u202fm, remain rare. The synergistic effects of hydrocarbon toxicity and hypobaric hypoxia in such environments are inadequately characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 23-year-old man accidentally aspirated approximately 10\u202fmL of diesel while siphoning a fuel line at 4,200\u202fm altitude. Within 5\u202fh, he developed nausea, vomiting, and dry cough, progressing to right-sided pleuritic chest pain, fever (38.2\u202f\u00b0C), and hypoxemia (SpO\u2082 84%). Arterial blood gas analysis revealed type I respiratory failure (PaO\u2082 44.8\u202fmmHg). Chest CT demonstrated patchy consolidations in the right middle lobe and left lower lobe. Laboratory findings included leukocytosis (15.9\u202f\u00d7\u202f10\u2079\/L) and elevated C-reactive protein (72.51\u202fmg\/L). Management comprised supplemental oxygen, broad-spectrum antibiotics (meropenem covering anaerobes and Gram-negative bacteria), intravenous methylprednisolone, and nebulized mucolytics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Diesel\u2019s lipophilic and irritant properties disrupt the alveolar-capillary barrier, inciting intense inflammation and pulmonary edema. At high altitude, baseline hypoxemia (SpO\u2082 85\u201390%) synergistically exacerbates ventilation-perfusion mismatch and accelerates respiratory failure. Hypoxia-amplified inflammatory cascades and consequent pulmonary hypertension further increase right ventricular afterload.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diesel aspiration pneumonia may progress rapidly to life-threatening respiratory failure under hypobaric conditions. Early triple therapy (broad-spectrum antibiotics, systemic corticosteroids, supplemental oxygen) is critical to mitigate complications. This case underscores the imperative for occupational safety interventions prohibiting oral siphoning and heightened vigilance for toxic-hypoxic interactions at high altitude.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1802060","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:20:52Z","timestamp":1776140452000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid-onset respiratory failure following diesel aspiration at 4,200\u202fm: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Bai","sequence":"first","affiliation":[{"name":"The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army","place":["Lanzhou, China"]},{"name":"The 944th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army","place":["Jiuquan, 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