[Lipid pneumonia and superinfection by Mycobacterium fortuitum. Apropos of a case].
We report a case of lipoid pneumonia complicated by supra-infection with Mycobacterium fortuitum. The diagnosis of a lipoid pneumonia was suggested by the CT Scanner which showed a negative density in the pneumonic tissue. The supra-infection by the mycobacterium dit not change the radiological opacities which stayed the same following a cure of the mycobacterial infection. A histo-pathological study showed evidence of macrophages with voluminous lipid inclusions but equally the atypical mycobacteria were associated with a giant cell-epithelioid reaction. In patients with a lipoid pneumonia the possibility of an infection should be considered and a supra-infection with an atypical mycobacterium should be looked for. At the same time, when a bacteriological study of sputum or fibreoptic aspiration of a rapidly growing mycobacterium is obtained this should raise the possibility of oil inhalations. Alveolar lavage seems to be a technique which seems to be entirely appropriate to obtain the diagnosis of the two concomitant disorders.