Successful Treatment of Severe Hydrocarbon Pneumonitis With Polysorbate 80 Lung Lavage: A Case Report Publisher



Asadi S ; Roostaei G ; Kazemizadeh H ; Khoshnamrad N ; Jahanbin B ; Abtahi H ; Firouzbakhsh S ; Yousefimokri M
Source: SN Comprehensive Clinical Medicine Published:2025

Abstract

Introduction: Lipoid pneumonia (LP), a rare lung injury caused by lipid aspiration, lacks standardized treatments. Diesel exposure poses significant risks due to hydrocarbon toxicity, often progressing to severe pneumonitis. We present a case of diesel-induced LP refractory to conventional therapy, successfully treated with polysorbate 80 lung lavage. Case Presentation: A 46-year-old male with diesel tank immersion history presented with dyspnea, low peripheral oxygen saturation (SpO₂ 88% on room air), and fever 1-month post-exposure. Imaging revealed right lower lobe consolidation; bronchoscopy identified lipid-laden macrophages. Despite 14 days of antibiotics, corticosteroids, and oxygen therapy, his SpO₂ worsened to 84% on room air. Segmental lung lavage using 150 mL of 0.1% polysorbate 80 in Ringer’s lactate was performed. Within days, oxygen saturation improved to 95%, inflammatory markers normalized (CRP: 117 → 4 mg/dL), and imaging showed near-complete resolution. The patient was discharged on day 35 without complications. Conclusions: Polysorbate 80 lavage effectively resolved diesel-induced LP in this steroid-refractory case, likely by emulsifying and removing alveolar lipids. This approach warrants further investigation as a therapeutic option for severe hydrocarbon pneumonitis. Multicenter studies are needed to establish safety, dosing, and long-term outcomes. © 2025 Elsevier B.V., All rights reserved.