Metal Fume-Induced Diffuse Alveolar Damage

Abstract

Metal fume fever is a well-defined clinical entity characterized by a self-limited influenza-like illness. Severe and protracted illness related to metal fume exposure is rare. We describe 2 related cases of serious metal fume fever in a 29- and a 51-year-old male precipitated by the use of an acetylene torch to dismantle galvanized steel in a poorly ventilated area. Each case was unusual in both severity and duration of symptoms for metal fume exposure. High-resolution computed tomography scans revealed diffuse alveolar damage in both patients. The 29-year-old male was started on steroids 1-day after exposure and experienced a significantly attenuated course of symptoms compared with the 58-year-old male, who received treatment 3 days after exposure.