Iatrogenic mediastinitis in bronchiolitis: Importance of avoiding pharyngeal aspiration

An 11-month-old infant was hospitalized for his first episode of severe bronchiolitis, with pneumomediastinum on the chest x-ray performed in the emergency room before hospitalization. After a few days, the occurrence of a feverish torticollis motivated a CT scan, revealing mediastinitis. An iatroge...

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Published inArchives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 26; no. 5; pp. 295 - 297
Main Authors Le Roch, M., Thebault, E., Beaudoin, S., Rubinsztajn, R., Chevallier, B., Tavière, V., Benoist, G.
Format Journal Article
LanguageEnglish
Published France Elsevier Masson SAS 01.07.2019
Elsevier
Subjects
Bronchiolitis
Bronchiolitis - therapy
Esophagus - injuries
Humans
Infant
Life Sciences
Male
Mediastinitis
Mediastinitis - diagnosis
Mediastinitis - etiology
Nasopharyngeal aspiration
Suction - adverse effects
Nasopharyngeal aspiration
Mediastinitis
Bronchiolitis
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Summary:An 11-month-old infant was hospitalized for his first episode of severe bronchiolitis, with pneumomediastinum on the chest x-ray performed in the emergency room before hospitalization. After a few days, the occurrence of a feverish torticollis motivated a CT scan, revealing mediastinitis. An iatrogenic perforation was objectified in the posterior wall of the esophagus, probably caused by nasopharyngeal aspiration. This exceptional case has never been reported before, except in premature infants. This encouraged us to report this case to change systematic aspiration practices and prefer nasal suctioning in healthy infants with bronchiolitis presenting to the emergency department.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:0929-693X
1769-664X
DOI:10.1016/j.arcped.2019.05.009