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March 18, 1974

Barium Enema Septicemia

Author Affiliations

University of Kansas Medical Center Kansas City

JAMA. 1974;227(11):1258-1259. doi:10.1001/jama.1974.03230240016004

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To the Editor.—  The report by Richman et al (226:62, 1973) concerned barium enema septicemia. Recently, we also saw a young infant develop sepsis after a barium enema examination.

Report of a Case.—  A 7-week-old white male infant was admitted because of constipation, abdominal distension, and failure to thrive. The lethargic and dehydrated infant's abdomen was grossly distended and tympanic to percussion, with normal bowel sounds. A roentgenogram showed gas and feces scattered throughout the colon and small bowel with no evidence of mechanical obstruction. The infant was rehydrated with intravenous fluid. A barium enema examination was reported as normal with complete evacuation of the contrast media after 12 hours. Nasogastric and rectal tubes were inserted for decompression. On the fourth day of hospitalization, a rectal biopsy revealed normal ganglion cells. The infant became febrile (38.8 C [102 F]), more lethargic, and had diarrhea approximately 72 hours after the barium