Affiliations: Department of Pediatric, Division of Pediatric Critical Medicine, St. Peter’s University Hospital, New Brunswick, NJ, USA
Note: [] Corresponding author: Tiong G. The, 254 Easton Avenue, New Brunswick, NJ 08901, USA. Tel.: +1 732 745 8600 x 8783; Fax: +1 732 745 0857; E-mail: tthe@saintpetersuh.com.
Abstract: Within hours of accidental instillation of a popular diaper rash protector spray, a 23 day old male developed severe chemical pneumonitis, acute respiratory failure and pneumomediastinum. Despite optimal ventilatory management, the unconventional use of frequent bronchial saline lavages was necessary to maintain oxygenation and ventilation. The only listed active ingredient, 10% dimethicone was a non-toxic inhalant, but the undisclosed inactive ingredients included mineral oil and balsam of peru which may cause chemical pneumonitis and allergic reactions. This case serves as a warning on OTC product designs and formulations, and cautions us to search beyond the listed active ingredients for potential toxicity.
Keywords: Chemical pneumonitis, pneumomediastinum, over the counter products design, unintended use, toxicity, neonate
