Metal fume fever

Background
  • 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[1]) 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

Clinical Features

Differential Diagnosis

Influenza-Like Illness


Evaluation
  • Clinical diagnosis, evaluate for alternate diagnoses
  • CXR and CT chest often unremarkable in milder cases but may show ground-glass opacities or other findings[2]
  • CBC- may have leukocytosis with neutrophil predominance[3]

Management
  • Supportive
  • Most cases self-limiting within 24-48h

Disposition
  • Discharge if clinically stable

See Also



References
  1. https://www.twi-global.com/technical-knowledge/faqs/faq-what-is-metal-fume-fever
  2. 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.
  3. 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.
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