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


METHODS
Case report.


METHODS
A tertiary care University-affiliated hospital.


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.
Atwa
Khalid
K
Pediatric Critical Care Medicine, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates.
Abuhasna
Said
S
Shihab
Zuhair
Z
Hashaykeh
Nidal
N
Hasan
Rashed
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000402:Airway Obstruction / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D044148:Lymphatic Abnormalities / Q000188:drug therapy*; D010431:Pentoxifylline / Q000627:therapeutic use; D011859:Radiography; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D010431:Pentoxifylline