Objective To explore the clinical characteristics of exogenous lipid pneumonia (ELP).

Methods The predisposing factors, clinical manifestations, imaging changes, treatment and prognosis of 13 patients with ELP in Zhongshan Hospital, Fudan University from January 2007 to November 2020 were analyzed retrospectively.

Results Eight patients (61.5%) with ELP were caused by intestinal obstruction and inhalation of oral paraffin oil. The main clinical manifestations were cough (10 cases, 76.9%) and fever (9 cases, 69.2%). 84.6% (11/13) patients had elevated C-reactive protein, while only 15.4% (2/13) patients had elevated procalcitonin. Chest CT showed that most of the lesions occurred in both lower lungs, and the common changes were ground glass shadow (84.6%, 11/13) and consolidation (69.2%, 9/13). The average time from symptom onset to diagnosis was 60 days. In addition to avoiding the aspiration of lipid substances, 61.5% (8/13) patients were treated with glucocorticoid.

Conclusion The clinical manifestations and chest CT changes of ELP are not typical and are easy to be misdiagnosed. Avoiding lipid aspiration is the key to prevent ELP, and early detection and early intervention is the key to treat the disease.