Bronchiolitis Obliterans Following Exposure to Nitrogen Oxides (Subacute Pulmonary Toxicity)

 

The patient gives a history of:

(1) a recent exposure to a nitrogen oxide, usually 10 to 30 days before

(2) a variable history of a delayed onset of acute lung injury (see previous section) with apparent recovery

 

Clinical findings:

(1) fever and chills

(2) cough

(3) dsypnea

(4) rales and wheezing

(5) hypoxia

 

Pulmonary function testing shows evidence of both obstructive and restrictive patterns.

 

Chest X-rays show either changes of acute lung injury or a miliary pattern of small, discrete nodules.

 

Biopsy of the lungs shows evidence of bronchiolitis obliterans.

 

Respiratory failure may occur which can be fatal.