title: Activated charcoal laryngitis in an intubated patient.
abstract: Activated charcoal is useful in the management of poisonings, but it is not harmless. We report the case of a patient who developed obstructive laryngitis secondary to aspiration of activated charcoal with a protected airway.
  
  
  METHODS
  A 2-year-old girl presented acute mental alteration secondary to presumed poisoning. Mechanical ventilation was initiated, and a single dose of activated charcoal was administered. She had an episode of vomiting during the respiratory weaning. Black-tinted tracheal secretions were suctioned through the tube immediately. Pulmonary auscultation and radiologic examination were normal. When she was extubed, she developed obstructive laryngitis. Fiberbronchoscopy was performed and showed edema and a significant amount of charcoal particles on the epiglottis, arytenoids, and arytenoepiglottic folds. Charcoal particles were removed by bronchoscopy successfully. Later evolution was normal, and no symptoms were present when she was discharged at home.
  
  
  CONCLUSIONS
  Obstructive laryngitis is a new major complication of activated charcoals use in upper airway. It is remarkable that this complication occurred in a protected airway. Charcoal is not an innocuous agent. This case shows that nasogastric administration of activated charcoals presents a significant degree of risk.
authors.affiliation: Pediatric Critical Care Area, Padre Hurtado Hospital, Santiago, Chile, South América. adonoso@hurtadohosp.cl
authors.forename: Alejandro
authors.initials: A
authors.lastname: Donoso
authors.forename: Marcela
authors.initials: M
authors.lastname: Linares
authors.forename: José
authors.initials: J
authors.lastname: León
authors.forename: Gloria
authors.initials: G
authors.lastname: Rojas
authors.forename: Cristián
authors.initials: C
authors.lastname: Valverde
authors.forename: Milena
authors.initials: M
authors.lastname: Ramírez
authors.forename: Bernd
authors.initials: B
authors.lastname: Oberpaur
mesh_terms: D002606:Charcoal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D003951:Diagnostic Errors; D004829:Epilepsy, Generalized / Q000175:diagnosis; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D007827:Laryngitis / Q000139:chemically induced*; D011015:Pneumonia, Aspiration; D011041:Poisoning / Q000175:diagnosis / Q000628:therapy; D012121:Respiration, Artificial; D015300:Ventilator Weaning; D014839:Vomiting / Q000150:complications
chemical_list: D002606:Charcoal