key: cord-0014889-18sg44j3
authors: Davison, Gail; Given, Andrew; Loughran, Clare; Marjanovic, Josip; Dalzell, Elizabeth
title: Perioral petechiae and pulmonary haemorrhage, thinking outside the vacuum
date: 2021-01-20
journal: BMJ Case Rep
DOI: 10.1136/bcr-2020-240282
sha: c1808bd9b222918639fa34b97f356e397eb6197c
doc_id: 14889
cord_uid: 18sg44j3

nan

A 3-month-old boy presented to the children's emergency department with respiratory distress, haemoptysis, and perioral petechiae (figure 1). He was pale and floppy, with tachypnoea, hypoxia (SpO 2 84%), bilateral crepitations, and wheeze. His white cell count was mildly elevated (20.5 ×10 9 /L), and a chest X-ray (CXR) showed (figure 2) bilateral air-space opacification; a non-specific finding with differentials including oedema, infection, or haemorrhage.

His older brother subsequently admitted to holding a vacuum cleaner nozzle against his mouth, confirming the mechanism of injury and diagnosis of pulmonary haemorrhage. He required a short period of oxygen therapy and overnight admission. A thorough assessment revealed no social concerns and a repeat CXR 2 days later had improved.

A MEDLINE keyword search was completed using the following terms: "(vacuum cleaner* or hoover* or household vacuum*) adj10 (injur* or h?emoptysis or h?emorrhage*)". It revealed four relevant articles reporting 13 cases of vacuum cleaner inflicted hand burns in children and 2 auto-stimulation penile injuries in adolescents. [1] [2] [3] [4] There were no acute lung injuries reported.

For most households, a domestic vacuum cleaner is an essential appliance frequently used by both parents and children and actively promoted as a comforter. To date, injuries have been relatively minor. We present the first case of severe and potentially life-threatening acute lung injury from this appliance.

► Paediatricians, manufacturers, and parents should be aware of the risk of vacuum cleaner inflicted pulmonary haemorrhage in young children. ► Manufacturers should display a child safety warning on vacuum appliances. ► Parents should keep vacuum appliances out of reach of children to reduce risk in the home.

Contributors All authors read and approved the final manuscript. GD provided study conceptualisation and design, completion of relevant searches and preparation of manuscript including figures. AG provided study conceptualisation and design, and preparation of manuscript. CL provided study conceptualisation and design, including critical revision. JM provided study conceptualisation and design, including critical revision. ED provided study conceptualisation and design, including critical revision.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. 

Vacuum cleaner injury to penis: a common urologic problem?

Hand injuries in young children from contact with vacuum cleaners

Upper extremity friction burns in the pediatric patient: a 10-year review

Paediatric friction hand injuries caused by domestic vacuum cleaners-a review from one unit

Patient consent for publication Parental/guardian consent obtained.Provenance and peer review Not commissioned; externally peer reviewed.

Gail Davison http:// orcid. org/ 0000-0003-4875-8331Copyright 2021 BMJ Publishing Group. All rights reserved. For permission to reuse any of this content visit https://www.bmj.com/company/products-services/rights-and-licensing/permissions/ BMJ Case Report Fellows may re-use this article for personal use and teaching without any further permission.Become a Fellow of BMJ Case Reports today and you can: ► Submit as many cases as you like ► Enjoy fast sympathetic peer review and rapid publication of accepted articles ► Access all the published articles ► Re-use any of the published material for personal use and teaching without further permission

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