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Case Presentation: A 65-year-old man was referred for evaluation of several years of chest congestion and cough productive of yellow sputum as well as recently noted abnormalities on chest imaging. He denied dyspnea, weight loss, fevers, chills, or hemoptysis. He had no history of systemic illness, pneumonia, other respiratory illness, gastroesophageal reflux, or sinusitis. He had a remote smoking history. He worked as a railroad conductor and had occupational exposure to asbestos, as well as to other uncharacterized dusts and fumes. The patient spent most of his life in Washington and California and regularly traveled through the California Central Valley. Other travel history included trips to Southeast Asia, Iceland, and Europe in the remote past. The patient had one dog but no exposure to other animals. His only medication was loratadine, taken daily for allergic rhinitis. He applied petroleum jelly to his nares nightly to moisturize his nasal passages., (Copyright © 2019. Published by Elsevier Inc.)

We report a case of fat deposit pneumonia extending to the parietal pleura with a granulomatous reaction centered on the fat vaculoles. This case was complicated by an atypical and fatal mycobacterial infection caused by Mycobacterium chelonae. The severity of Mycobacterium chelonae infection in fat deposit pneumonia warrants early empirical antibiotic therapy.

We report the case of a nonimmunocompromised female patient, who developed exogenous lipoid pneumonia with Mycobacterium fortuitum infection at diagnosis, later followed by Aspergillus fumigatus infection. The association of exogenous lipoid pneumonia with atypical mycobacterial infection is uncommon but well-recognized, but, to our knowledge, association with A. fumigatus infection has not previously been reported.

We report a fatal case of lipoid pneumonia in a two and one half month old Saudi female caused by aspiration of animal fat, ghee and complicated by Mycobacterium fortuitum infection. It highlights the need to look for M. fortuitum in lipoid pneumonia and suggests the prevention of the condition through health education.

The case is described of a patient with a tracheostomy subsequent to laryngectomy for carcinoma, who developed a pleuro-pulmonary infection due to Mycobacterium smegmatis complicating lipoid pneumonia after prolonged instillation of gomenol oil into the tracheostoma. The adjuvant property of lipids for the development of respiratory infections due to M. smegmatis and other rapid-growing mycobacteria is discussed in the light of the cases described in the literature.

Two patients had pulmonary infections with atypical mycobacteria superimposed on mineral oil pneumonia. In both cases, long-standing laxative use and neurological disorders led to development of the lipid pneumonia. The pathogenicity of the rapidly growing mycobacteria causing infection in the two patients is apparently enhanced by the presence of mineral oil, a relationship supported by experimental studies. The clinical diagnosis of both atypical mycobacterial infection and mineral oil pneumonia may be difficult, but the presence of one should suggest the possibility of occurrence of the other.