Exogenous lipoid pneumonia in children: A systematic review

Paediatr Respir Rev. 2020 Feb:33:45-51. doi: 10.1016/j.prrv.2019.01.001. Epub 2019 Jan 20.


Objectives: To describe the clinical-radiological-pathological characteristics and treatment outcomes of children with suspected exogenous lipoid pneumonia (ELP).

Design: Systematic review. We searched electronic databases and reference lists published between 1967 and 2018, restricted to non-accidental cases.

Results: Forty-four studies including 489 participants aged 1 day to 17 years from 13 countries were included. Cultural, medical, and behavioural rationale for oil-use was described. The clinical-radiological presentation varied widely. Diagnostic certainty was deemed highest if ELP was confirmed on bronchoalveolar lavage/frozen section lung biopsy with documented extracellular lipid on cytological staining and/or fat analysis. Non-tuberculous mycobacteria infection was identified in six studies: Mycobacterium fortuitum/chelonei, Mycobacterium smegmatis and Mycobacterium abscessus. Treatment comprised supportive therapy, corticosteroids, stopping oil, therapeutic lung-lavage and surgical resection. Outcomes were reported inconsistently.

Conclusion: Paediatric ELP resulting from cultural and medical practices continues to be described globally. Preventive interventions, standardized reporting, and treatment efficacy studies for cases not averted, are lacking. Protocol registration: PROSPERO CRD42017068313.

Keywords: Children’s interstitial lung disease (chILD); Global Health; Oil.

Publication types

  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Biopsy
  • Bronchoalveolar Lavage
  • Chest Pain
  • Child
  • Constipation / therapy
  • Cough
  • Culture*
  • Dietary Supplements
  • Humans
  • Hypoxia
  • Laxatives / therapeutic use
  • Mouthwashes / therapeutic use
  • Mycobacterium Infections, Nontuberculous / complications
  • Nasal Lavage
  • Oils / adverse effects*
  • Oils / therapeutic use
  • Osteoarthropathy, Primary Hypertrophic
  • Oxygen Inhalation Therapy
  • Palliative Care
  • Pneumonia, Bacterial / complications
  • Pneumonia, Lipid / diagnostic imaging
  • Pneumonia, Lipid / etiology*
  • Pneumonia, Lipid / microbiology
  • Pneumonia, Lipid / therapy
  • Pneumonia, Viral / complications
  • Respiration, Artificial
  • Risk Factors
  • Tachypnea
  • Tuberculosis, Pulmonary / complications


  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Laxatives
  • Mouthwashes
  • Oils