Celebrations with consequences: fever, dyspnea and chest pain

History We report on a 35-year-old male patient who presented to the emergency department a day after celebrations. The night before, the alcoholized patient tried to spit fire with an oily fuel paste. A fever, dyspnea and chest pain were present. Findings and Diagnosis The patient is febrile, but in reduced general conditions. In laboratory chemistry shows elevated inflammatory parameters. Due to the conventional radiology findings we completed the diagnostic with a CT-scan, which shows confirmed streaky opacities, especially in the middle lobe. Diagnosis Based on the very suggestive history and diagnostic findings, a fire eater's lung was diagnosed. Therapy and course Under treatmen with CoAmoxicillin, oxygen, inhalation with Ipratropiumbromid/Salbutamol and symptomatic treatment, we could reach a clinical improvement and discharged within three days. Conclusion Aspiration of oily fuel paste led to lipoid pneumonia. Few such cases have been described so far, but the medical history, symptoms and radiological imaging are very characteristic. Antibiotic therapy is not primarily necessary, however, depending on the clinical condition may help to prevent bacterial superinfection. The administration of systemic steroids is controversial in this situation.