Subject(s)
Death , Grief , Neoplasms/therapy , Palliative Care/psychology , Physicians/psychology , Adolescent , Female , Humans , Leukemia/therapy , Male , Medical Oncology , Narration , Pediatrics , Physician-Patient Relations , Professional-Family Relations , Recurrence , Rhabdomyosarcoma/therapy , Salvage Therapy/psychologyABSTRACT
OBJECTIVE: To describe the successful use of surfactant for treatment of respiratory distress refractory to conventional mechanical ventilation in a 4-wk-old with pulmonary hemorrhage. DESIGN: Case report. SETTING: Tertiary care center pediatric intensive care unit. PATIENT: Four-week-old infant. MAIN RESULT: Clinical improvement of respiratory distress as evidenced by 50% reduction in oxygenation index and subsequent extubation. CONCLUSION: Pulmonary hemorrhage is a rare but potentially fatal condition in children. Previously described therapeutic approaches include high-frequency oscillation ventilation and extracorporeal membrane oxygenation. Infants with pulmonary hemorrhage and respiratory distress may benefit from a trial of surfactant before escalating care.
Subject(s)
Hemorrhage/drug therapy , Lung Diseases/drug therapy , Pulmonary Surfactants/therapeutic use , Hemorrhage/physiopathology , Humans , Infant, Newborn , Lung Diseases/physiopathology , Male , Pulmonary Alveoli/drug effects , Pulmonary Surfactants/pharmacology , Respiration, Artificial , Respiratory Insufficiency/drug therapy , Respiratory Insufficiency/etiology , Respiratory Insufficiency/physiopathology , Treatment OutcomeABSTRACT
We report a case of Legionella pneumonia in a 10-year-old girl with idiopathic pulmonary hemosiderosis who was chronically immunosuppressed and had exposure to a hot tub. Prompt diagnosis with bronchoalveolar lavage and subsequent antimicrobial therapy resulted in full recovery. Legionellosis should be included in the differential diagnosis of the immunosuppressed child with respiratory illness. High risk patients should avoid exposure to hot tubs.
