Background: Practices of manual siphoning of fuel around the globe has exponentially increased the incidence of chemical pneumonitis. As evident by studies, chemical pneumonitis constitutes quite significant proportion of community-acquired pneumonia. In this case report, we follow up on the case of hydrocarbon pneumonitis along with its diagnostic uncertainty and treatment challenges. Case Presentation: A 66-year-old male presented with shortness of breath, fever, and hemoptysis after accidentally aspirating diesel while siphoning it from a generator. computed tomography pulmonary angiogram revealed bilateral pneumonitis and ruled out pulmonary embolism. He required high-flow oxygen initially due to extensive nature of pneumonia and was managed conservatively with broad-spectrum antibiotics and steroids. He recovered to discharge after 21 days. This represents a case of chemical, hydrocarbon (exogenous lipoid) pneumonitis, complicated by transudative pleural effusion and likely bacterial superinfection. Conclusion: Chemical pneumonitis is associated with varied symptoms and radiological presentation. Its treatment is essentially same as pneumonia caused by other pathogens. Timely diagnosis, escalation, and treatment can reduce the morbidity and mortality caused by these harmful insults.

Keywords: Siphonage, inhalation, hydrocarbon pneumonitis, aspiration.