Rare cause of chronic cough in a young healthcare worker - A case of exogenous lipoid pneumonia!

Exogenous lipoid pneumonia (ELP) is a rarely reported entity caused by aspirating or inhaling fat or oil-containing substances. Clinically, patients present with subacute to chronic-onset non-specific symptoms such as cough, fever, breathlessness, and general malaise. In addition, lobar or multifocal interstitial and parenchymal infiltrates on chest imaging can mimic any other infectious etiology. Diagnosis of lipoid pneumonia is often missed or delayed in many cases and requires a high index of clinical suspicion. We report a case of a 36-year-old nursing officer who presented with a cough and right-sided pneumonia on chest imaging. She was being treated empirically with antitubercular therapy without any clinical response to the treatment. ELP was diagnosed after carefully evaluating the radiological findings, reviewing the clinical history, and finding supportive evidence of lipid-laden alveolar macrophages in her broncho-alveolar lavage fluid. It is vital to uphold a heightened clinical suspicion for non-infectious etiologies in non-resolving pneumonia and investigate the patient thoroughly before resorting to empirical treatments.