A 19-year-old Army corporal was admitted after accidentally aspirating JP-8 jet fuel during siphoning. His pulmonary status rapidly deteriorated requiring intubation with the development of massive necrotic abscesses with air-fluid levels (Figure 1, asterisks) in his right lung. Two thoracotomy tubes were inserted (Figure 1, arrow). He continued to be febrile despite the use of broad-spectrum antibiotics but gradually improved after their discontinuation and was extubated. A bronchoscopy was performed that revealed inflamed, hyperemic mucosa without purulence or evidence of necrosis. Repeat computed tomography scan 3 days before discharge showed remarkable improvement (Figure 2). No surgical interventions were required.
CT of chest with IV contrast shows extensive involvement of right lung parenchyma with thoracotomy tube visible (arrow), abscesses with air-fluid levels (asterisks), and a right-sided loculated pleural effusion.
Repeat noncontrast-enhanced CT of the chest done 3 weeks later reveals marked improvement in the right lung with minimal residual scarring.
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Cite this: A Case of Fire-eater's Pneumonia in an Active-Duty Soldier - Medscape - Jun 06, 2006.