Metal Fume Fever

Exposure

  • Zinc Oxide: welding of galvanized metal or brass
  • Magnesium: limited evidence that magnesium may cause metal fume fever
  • Copper (see Copper, [[Copper]]): limited evidence that copper fumes may cause metal fume fever

Physiology

  • Inhalational Exposure to Metal Fumes
    • Possibly cytokine-mediated

Diagnosis

  • CXR/Chest CT: usually normal (if infiltrates are present, should suggest alternative diagnosis)
  • CBC: leukocytosis may be seen
  • ABG: hypoxemia is usually absent
  • FOB-BAL: marked influx of neutrophils

Clinical

(onset of symptoms 4-8 hrs after acute inhalation of fumes or dust)

  • Mild Dyspnea (see Dyspnea, [[Dyspnea]])
  • Cough (see Cough, [[Cough]])
  • Fever (see Fever, [[Fever]])
    • “Monday Morning Fever”: tachyphylaxis (blunted response) may occur after repeated exposures throughout the week, so symptoms are usually worse on first day of the work week
  • Flu-Like Syndrome
    • Malaise
    • Chills
    • Myalgias

Treatment

  • Self-Limited: usually spontaneously resolves within 12-48 hrs

References

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