Metal fume fever
- AKA brass founders' ague, brass shakes, zinc shakes, galvie flu, metal dust fever, Welding Shivers, Monday morning fever
- Syndrome caused by inhalation of certain metals (most commonly zinc, copper, cadmium, but also aluminum, lead, nickel and various other metals) in form of dust or fumes, usually through hot metalworking such as welding, brazing, smelting, or soldering.
- Thought to be due to metals stimulating cytokine release
- Flu-like illness; fever, fatigue/malaise, myalgia, arthralgia, myalgia, headache
- Usually resolves in 24-48h
- +/- SOB, chest pain, pneumonitis
- Rarely, severe lung injury, ARDS picture
- +/- hypotension, LOC, seizure, AKI in severe cases
- Clinical diagnosis, evaluate for alternate diagnoses
- CXR and CT chest often unremarkable in milder cases but may show ground-glass opacities or other findings
- CBC- may have leukocytosis with neutrophil predominance
- Most cases self-limiting within 24-48h
- Discharge if clinically stable
- Kunimasa, Kei; Arita, Machiko; Tachibana, Hiromasa; Tsubouchi, Kazuya; Konishi, Satoshi; Korogi, Yohei; Nishiyama, Akihiro; Ishida, Tadashi (2011). "Chemical Pneumonitis and Acute Lung Injury Caused by Inhalation of Nickel Fumes". Internal Medicine. 50 (18): 2035–8.
- Kaye P, Young H, O'sullivan I. Metal fume fever: a case report and review of the literature. Emerg Med J. 2002;19(3):268-9.