Negative pressure pulmonary edema and hemorrhage after near fatal suffocation in an infant: a case report

Background: Pulmonary hemorrhage is rare but potentially life-threatening in children. Many causes are usually described, as cardiogenic, infective or immune. Pulmonary hemorrhage related to negative pressure pulmonary edema (NPPE) is uncommon in the pediatric population and there is limited literature about it. This is one of the few case reports regarding NPPE in infants presenting with pulmonary hemorrhage. Case presentation: We describe the story of a 6-weeks-old boy who presented epistaxis and hemoptysis associated with symptoms related to NPPE after near fatal suffocation. Radiological findings were consistent with alveolar hemorrhage. Supportive therapy was performed, with clinical recovery within a few days and radiological normalization within one month. Conclusion: NPPE associated with pulmonary hemorrhage is a dramatic condition but usually has a quick recovery with just supportive therapy. The aim of our report is to increase the awareness and emphasizes the importance of including this entity in the differential diagnosis of pulmonary hemorrhage in children with a suspicious anamnestic history of upper airway obstruction.