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The clinical course of TOS has three different phases.

Basically, the acute phase was characterized by an insterstitial-alveolar pattern in the chest X-ray. Some days later higher figures of eosinophilia were seen. Other general symptoms were present in most of the patients.

During this phase a lot patients died due to respiratory insufficiency secondary to non-cardiogenic pulmonary oedema

Kilbourne EM, Rigau Perez JG, Heath CWJ, et al. Clinical epidemiology of toxic-oil syndrome. Manifestations of a New Illness. N Engl J Med 1983;309(23):1408-14.

Toxic Epidemic Syndrome Study Group. Toxic epidemic syndrome, Spain, 1981.. Lancet 1982;2(8300):697-702.