CTICasesAcute Inhalation Injury from Mineral Oil Smoke Simulant in a Firefighter
Imaging findings
Chest radiograph in an acutely ill firefighter shows bilateral peripheral ground-glass opacities with consolidation. CT shows confluent bilateral peripheral ground-glass opacities with consolidation, predominantly peripheral in distribution with some upper lobe concentration. The findings developed 3 days after exposure to simulated smoke from a mineral oil-based training device used during a drill without a respirator. Multiple colleagues were also affected though less severely. The patient improved relatively quickly without steroid treatment.
Key takeaways
Mineral oil-based smoke simulants used in firefighter training drills can cause acute lung injury when inhaled without respiratory protection, producing a CT pattern of bilateral peripheral ground-glass and consolidative opacities resembling organizing pneumonia or eosinophilic pneumonia. The acute onset in the occupational context of smoke simulator training, particularly with multiple affected colleagues, is the critical diagnostic clue. Organizing pneumonia-like opacities from acute inhalation injury often improve spontaneously or with steroids. The mechanism is direct chemical injury from the aerosolized mineral oil mist.
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