Polymer fume fever

Last revised by Daniel J Bell on 12 Mar 2021

Polymer fume fever is a rare condition secondary to the breathing in of fumes from PTFE, a common household plastic. It is often misdiagnosed as a viral flu-like illness. Most people make a rapid recovery, although severe morbidity may be seen.

A Japanese group found 18 cases of polymer fume fever in the literature in which pulmonary edema/ARDS had been diagnosed. 

Men accounted for all the cases, bar two (~90%) and the majority of patients were smokers and 80% had no known comorbidities. 

One third were exposed in industry, one third due to fumes in overheated cookware in their homes, and one third from smoking cigarettes which had been contaminated with PTFE. 

Cases of polymer fume fever tend to present with non-specific relatively mild respiratory and systemic symptoms:

  • breathlessness: commonest symptom
  • fever
  • sore throat
  • malaise
  • cough

An accompanying systemic inflammatory response syndrome (SIRS) is common.

The symptoms usually arise several hours following exposure to the fumes. Severity of the clinical presentation appears to correlate with duration of exposure and how high the pyrolytic temperature is 1. All reported cases have had a clear history of exposure to PTFE-related vapors.

Polytetrafluoroethylene (PTFE), better known by its first brand name, Teflon®, is commonly employed in both domestic and industrial settings due to several highly desirable attributes including an almost complete lack of friction, high melting point and high electrical insulation. 

PTFE is per se chemically inert and not known to be toxic to humans. However when exposed to high temperatures (at least 400°C) it may degrade (pyrolysis) into a vapor which manifests as polymer fume fever when inhaled.

Typically diffuse bilateral ground glass opacities are seen with a degree of peripheral sparing. Occasionally, patchy air space opacification is also present. The appearances are thought to represent a form of ARDS.

Most cases make a full recovery with no long term sequelae.

Death is a very rare occurrence; in a systematic review there was only one death in 18 cases, and this was despite ICU care 2.

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