Pneumonia due to liquid paraffin: with chemical analysis.

The first description of oil aspiration pneumonia in man was by Laughlen in 1925. He described 4 cases diagnosed at necropsy: 3 of the patients were infants and 1 was an adult. In 2 cases the administration of liquid paraffin by mouth was incriminated and in the other 2 oily nasal drops had been used. Pinkerton (1927) described 6 cases diagnosed at necropsy, 5 were infants and 1 was a 6-year-old boy. Of these, 5 had suffered from chronic ill-health; a history of mineral oil ingestion was obtained in 3 cases. Ikeda (1935) reported 7 cases collected from a series of 101 consecutive necropsies on children, and gave a lucid account of the pathological changes. In at least 2 liquid paraffin was thought to be the causative agent. Brimblecombe, Crome, and Tizard (1951) described a case of liquid paraffin pneumonia in a boy of 81 months, undiagnosed until necropsy. Bishop (1940) collected and reviewed 136, and Kaplan (1941) found references to 411 reported cases. More recently the American published reports were reviewed by Buechner and Strug (1956) and by Steinberg and Finby (1956). The majority of cases have not been diagnosed until necropsy. There are a few references to cases diagnosed in life, but most of them were adults with pulmonary oil granulomas. Thus Wagner, Adler, and Fuller (1955) presented 5 cases of liquid paraffin granulomas in adults, and Siddons (1958) reported 3 cases of oil granuloma initially diagnosed as carcinoma of the bronchus; in one of Siddon's cases it was established that liquid paraffin had been ingested. Cotton and Lloyd (1960) described another adult case, in which liquid paraffin pneumonia and nocardial infection complicated a long-standing case of achalasia of the cardia. In the majority of the recorded cases the diagnosis was made on purely histological grounds, and few authors have undertaken chemical extraction or attempted to identify the causative oil. In the 40 years since Laughlen's original report