FATAL PNEUMOCOCCAL SEPSIS FOLLOWING FLEXIBLE BRONCHOSCOPY IN AN IMMUNOCOMPROMISED INFANT

A 5-month-old boy who suffered from a leukocyte chemotactic defect und erwent flexible bronchoscopy for persistent right upper lobe atelectas is and tachypnea. Ten hours after the procedure he developed fulminant sepsis, and he died 16 hrs after bronchoscopy. Streptococcus pneumoni ae (serotype 23) grew from the bronchoalveolar lavage fluid and from t he blood culture taken during the sepsis work-up. We, therefore, sugge st administering prophylactic antimicrobial therapy immediately follow ing bronchoscopy to immunosuppressed children, even when an acute resp iratory infection is not suspected, in order to prevent bacteremia and sepsis. (C) 1998 Wiley-Liss, Inc.