Iatrogenic pleuropulmonary charcoal instillation in a teenager

Activated charcoal given through a nasogastric tube is a standard intervention for many types of toxic ingestions in the emergency department. This case study describes a teenage girl whose multidrug overdose was complicated by accidental charcoal instillation into her left lung and pleural space through a misplaced nasogastric tube. The ensuing empyema did not respond to antibiotic therapy alone, probably due to the inherent properties of charcoal, and required a chest tube placement with continuous irrigation. Unlike previously reported cases, this patient did well clinically, without long‐term morbidity. Pediatr Pulmonol. 2003; 35:490–493. © 2003 Wiley‐Liss, Inc.