Volume 45, Issue 2 pp. 192-196
Case Report

Acute pulmonary toxicity following intralesional administration of bleomycin for a lymphovenous malformation

Khalid Atwa MD, MS

Khalid Atwa MD, MS

Pediatric Critical Care Medicine, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates

Acting Chief.

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Said Abuhasna MD

Said Abuhasna MD

Department of Critical Care Medicine, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates

Chief, Department of Critical Care Medicine.

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Zuhair Shihab MD

Zuhair Shihab MD

Department of Critical Care Medicine, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates

Attending Physician.

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Nidal Hashaykeh MD

Nidal Hashaykeh MD

Department of Critical Care Medicine, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates

Attending Physician.

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Rashed Hasan MD, FAAP

Corresponding Author

Rashed Hasan MD, FAAP

Mercy Children's Hospital, Toledo, Ohio

Attending Physician.

Associate Director, Pediatric Critical Care, Mercy Children's Hospital, Toledo, OH.Search for more papers by this author
First published: 01 December 2009
Citations: 34

Abstract

Objective

To describe the clinical course and treatment of an infant with acute pulmonary toxicity following intralesional administration of bleomycin for a lymphovenous malformation.

Design

Case report.

Setting

A tertiary care University-affiliated hospital.

Patient, Intervention, and Results

An 8-month-old girl developed acute respiratory distress with profound hypoxemia complicated by pneumothorax and pneumomediastinum 1 day following intralesional administration of bleomycin. She was treated with bilateral chest tube insertion, systemic corticosteroids, pentoxifylline, and supportive care. At the most recent follow-up 5 months after the onset of the respiratory event, the patient is active, walks, and talks without any evidence of pulmonary diseases clinically. This is the youngest infant reported, to date, with acute bleomycin pulmonary toxicity following intralesional administration of bleomycin resulting in acute respiratory insufficiency followed by complete recovery.

Conclusions

This case illustrates the importance of early recognition and aggressive treatment of acute bleomycin toxicity resulting from intralesional administration of this medication for lymphovenous malformations. Pediatr Pulmonol. 2010; 45:192–196. © 2009 Wiley-Liss, Inc.

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