A 65-year-old woman in Kochi, severely injured after a stove explosion, was successfully treated at Amrita Hospital, Kochi, Kerala for a rare and life-threatening lung disorder.
The accident, which occurred while she was preparing a meal, resulted in inhalation of dense, toxic fumes from the kerosene stove. She was rushed to Amrita Hospital in critical condition, exhibiting alarming respiratory distress, and required ventilator support.
Upon thorough evaluation by the hospital’s pulmonary medicine team, led by Dr. Tinku Joseph, Chief Interventional Pulmonologist, the woman was diagnosed with pulmonary alveolar proteinosis (PAP). PAP is an uncommon condition characterized by abnormal accumulation of surfactant-derived fluid in the alveoli, leading to impaired gas exchange and respiratory failure. The inhalation of heated kerosene smoke triggered this rare manifestation.
To treat the condition, the medical team devised a strategy centered on repeated whole lung lavage. This complex and high-risk procedure involves infusing large volumes of warm saline into the airways to flush out the milky-white proteinaceous material that obstructs proper lung function. In this case, approximately 40 liters of warmed saline were used during a series of lavage sessions.
Whole lung lavage is an intricate procedure requiring precise coordination under anesthesia or sedation, utilizing double-lumen endotracheal intubation to ventilate one lung while the other is rinsed. In this woman’s case, successive lavage cycles effectively removed the fluid burden, gradually restoring alveolar function.
Following the intervention, the patient showed rapid improvement. Over the course of several days, she was gradually weaned off ventilatory support. Oxygen saturation stabilized, breathing normalized, and she regained the ability to perform routine respiratory functions independently. Once stable, she was discharged from the hospital in good health.
Amrita Hospital’s has been proficient in diagnosing and managing rare pulmonary emergencies through its advanced interventional pulmonology unit. Since its establishment in 2017, the department has performed thousands of high‑risk procedures—such as bronchoscopy, airway stenting, and whole lung lavage—as part of its mission to address complex pulmonary diseases.
Pulmonary alveolar proteinosis is exceedingly rare; it affects only a small fraction of the global population. The case underscores the vital role of advanced bronchoscopy units and multidisciplinary critical care teams in executing technically demanding interventions like lung lavage. Experts emphasize that early recognition and timely treatment are key to preventing irreversible respiratory failure.
Dr. Tinku Joseph noted that this case exemplifies how severe inhalational injuries may unmask or trigger rare pulmonary conditions. He stressed the institution’s readiness, possessing both the infrastructure and expertise needed to manage uncommon presentations in critical patients.
(Input from various sources)
(Rehash/Sakshi Thakar/MSM)