{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:15:21Z","timestamp":1790144121340,"version":"4.0.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"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. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This case report describes a rare pediatric case of exogenous lipoid pneumonia caused by repeated paraffin oil aspiration and highlights the importance of detailed exposure history, early recognition, and timely intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the clinical course, diagnostic assessment, treatment, and follow-up of a 4-month-old former preterm infant admitted to the pediatric intensive care unit with severe pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Repeated targeted history-taking revealed multiple oral administrations of liquid paraffin with choking episodes. Chest CT showed bilateral consolidation, ground-glass opacities, interlobular septal thickening, a crazy-paving pattern, and a focal area of fat attenuation. BALF cytology showed vacuolated histiocytes, although lipid-specific staining was unavailable.\n                      <jats:italic>Klebsiella aerogenes<\/jats:italic>\n                      was detected by throat-swab and BALF targeted next-generation sequencing and was isolated from sputum culture, supporting concomitant lower respiratory tract infection. Following discontinuation of paraffin exposure and multimodal management, the patient showed clinical and radiological improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exogenous lipoid pneumonia should be considered in infants with treatment-refractory pneumonia and intralesional fat attenuation on CT. Diagnosis requires integration of exposure history, imaging, BALF findings, microbiological evidence, and clinical course. Because several interventions were administered concurrently and long-term follow-up was incomplete, the efficacy of individual treatments and late pulmonary outcomes could not be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1929480","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:55:38Z","timestamp":1790142938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric exogenous lipoid pneumonia caused by paraffin oil aspiration: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Dingbo","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Pediatric Critical Care Medicine, Children\u2019s Medical Center, People's Hospital of Xiangxi Autonomous Prefecture, The First Affiliated Hospital of Jishou University, Clinical College of Jishou University","place":["Xiangxi, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayu","family":"Nie","sequence":"additional","affiliation":[{"name":"Pediatric Emergency, Children\u2019s Medical Center, People's Hospital of Xiangxi Autonomous Prefecture, The First Affiliated Hospital of Jishou University, Clinical College of Jishou University","place":["Xiangxi, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Third Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1016\/j.rmed.2010.12.001","article-title":"Exogenous lipoid pneumonia. Clinical and radiological manifestations","volume":"105","author":"Marchiori","year":"2011","journal-title":"Respir Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e9294","DOI":"10.7759\/cureus.9294","article-title":"Exogenous lipoid pneumonia complicated by mineral oil aspiration in a patient with chronic constipation: a case report and review","volume":"12","author":"Jeelani","year":"2020","journal-title":"Cureus"},{"key":"B3","first-page":"4264","article-title":"Lipoid (lipid) pneumonia.","volume-title":"Oxford Textbook of Medicine","author":"Bourke","year":"2020"},{"key":"B4","doi-asserted-by":"publisher","first-page":"109353","DOI":"10.5320\/wjr.v14.i1.109353","article-title":"Exogenous lipoid pneumonia associated with nasal decongestants use: a narrative review of an under recognized clinical entity","volume":"14","author":"Basit","year":"2025","journal-title":"World J Respirol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e00356","DOI":"10.1002\/rcr2.356","article-title":"Exogenous lipoid pneumonia: an important cause of interstitial lung disease in infants","volume":"6","author":"Marangu","year":"2018","journal-title":"Respirol Case Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1007\/s00405-023-08344-8","article-title":"Differences in the swallowing process of newborns and healthy preterm infants: first results with a non-invasive bioimpedance and electromyography measurement system","volume":"281","author":"H\u00fcbl","year":"2024","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"5437376","DOI":"10.1155\/2020\/5437376","article-title":"Development of swallowing function in infants with oral feeding difficulties","volume":"2020","author":"Han","year":"2020","journal-title":"Int J Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"106184","DOI":"10.1016\/j.earlhumdev.2024.106184","article-title":"Effect of feeding in elevated side-lying and paced bottle feeding on swallow-breathe coordination in healthy preterm infants \u2013 first results","volume":"201","author":"H\u00fcbl","year":"2025","journal-title":"Early Hum Dev"},{"key":"B9","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.clp.2021.11.019","article-title":"Novel ventilation strategies to reduce adverse pulmonary outcomes","volume":"49","author":"Keszler","year":"2022","journal-title":"Clin Perinatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"535","DOI":"10.3390\/children10030535","article-title":"Respiratory management of the preterm infant: supporting evidence-based practice at the bedside","volume":"10","author":"Tana","year":"2023","journal-title":"Children"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1596160","DOI":"10.3389\/fmed.2025.1596160","article-title":"Exogenous lipoid pneumonia due to medical aspiration of paraffin oil: a case report and literature review","volume":"12","author":"Li","year":"2025","journal-title":"Front Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3109\/15563650.2011.568269","article-title":"Does the aspiration of lamp oil increase the alveolar diffusion barrier for oxygen? Proving clinical findings in an in-vitro alveolar space chamber experiment [abstract]","volume":"49","author":"Hahn","year":"2011","journal-title":"Clin Toxicol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1097\/MOL.0000000000000987","article-title":"Alveolar macrophages: guardians of the alveolar lipid galaxy","volume":"36","author":"Little","year":"2025","journal-title":"Curr Opin Lipidol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e41628","DOI":"10.1016\/j.heliyon.2025.e41628","article-title":"PPARG\/SPP1\/CD44 signaling pathway in alveolar macrophages: mechanisms of lipid dysregulation and therapeutic targets in idiopathic pulmonary fibrosis","volume":"11","author":"Li","year":"2025","journal-title":"Heliyon"},{"key":"B15","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1016\/j.chest.2021.02.037","article-title":"Presenting clinicoradiologic features, causes, and clinical course of exogenous lipoid pneumonia in adults","volume":"160","author":"Samhouri","year":"2021","journal-title":"CHEST"},{"key":"B16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s11547-020-01230-x","article-title":"Exogenous lipoid pneumonia: when radiologist makes the difference","volume":"126","author":"Cozzi","year":"2021","journal-title":"Radiol Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.prrv.2019.01.001","article-title":"Exogenous lipoid pneumonia in children: a systematic review","volume":"33","author":"Marangu","year":"2020","journal-title":"Paediatr Respir Rev"},{"key":"B18","doi-asserted-by":"publisher","first-page":"215","DOI":"10.22271\/27069567.2022.v4.i1c.379","article-title":"A clinical approach to diagnosis and treatment of lipoid pneumonia","volume":"4","author":"Talib","year":"2022","journal-title":"Int J Adv Res Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.21776\/ub.mrj.2022.004.02.3","article-title":"Exogenous lipoid pneumonia","volume":"4","author":"Effendi","year":"2022","journal-title":"Malang Respir J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1555471","DOI":"10.3389\/fmed.2025.1555471","article-title":"Polyinfection secondary to exogenous lipoid pneumonia caused by aspiration of paraffin oil: a case report","volume":"12","author":"Yan","year":"2025","journal-title":"Front Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/crj.13273","article-title":"The efficacy and safety of therapeutic lung lavage for exogenous lipoid pneumonia: a systematic review","volume":"15","author":"Shang","year":"2021","journal-title":"Clin Respir J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/crj.13575","article-title":"The effect of therapeutic bronchoalveolar lavage in combination with glucocorticoids on children with acute exogenous lipoid pneumonia","volume":"17","author":"Yang","year":"2023","journal-title":"Clin Respir J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1809747","DOI":"10.3389\/fped.2026.1809747","article-title":"Clinical analysis of 12 cases of acute exogenous lipoid pneumonia in children","volume":"14","author":"Liu","year":"2026","journal-title":"Front Pediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1929480\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:55:39Z","timestamp":1790142939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1929480\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":23,"alternative-id":["10.3389\/fped.2026.1929480"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1929480","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"article-number":"1929480"}}