Mx of Accidental Talc Powder inhalation in an infant with su
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Case Report

A18 month female child was admitted for appearance of cough and respiratory distress after one hour from the inhalation of talc powder, accidentally happened during a nappy change. She was apyrectic and presented with cough and only a mild respiratory distress, tachypnea (40/minute), 98% oxygen saturation, heart frequency of 145/minute. On examination there was no evidence of cyanosis, the respiratory sounds were normal on both sides and other systems were normal. Chest x-ray revealed a consolidation in central and middle lung zones and basal emphysema on both sides (Figure 1a). An empirical treatment with intravenous antibiotic (Ceftriaxone at the dose of 50 mg/Kg) and steroids (Methylprednisolone at the dose of 1 mg/Kg/8 h) was done for five days. A topical treatment by aerosol with surfactant (Poractant Alfa), budesonide and salbutamol was added. Surfactant was given at the dose of 120 mg/1,5 ml and it was repeated after 12 hours; after then the aerosol therapy was administered only with budesonide (0,25 mg/dose) and salbutamol (2 mg/dose). Inhalation therapy was carried out with a pneumatic nebulizer and with a spacer chamber, with aiming to reduce oropharyngeal deposition and increasing distal bronchial deposition. A respiratory physiotherapy by clapping was performed twice a day for a week. Chest X-ray showed a clear improvement of the lung condition after five days of therapy, showing only an increased perihilar interstitial marking on both sides (Figure 1b). The respiratory functions preserved normal without signs of deterioration. Coughing has reduced till complete disappearance. On clinical follow-up we found no symptoms and signs of respiratory tract or pulmonary disease. Chest x-ray examinations performed at 1,5 and 6 months resulted normal....