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April 25, 1980

Latrogenic Acute Nasal Obstruction in an Obligate Nose Breather

JAMA. 1980;243(16):1657. doi:10.1001/jama.1980.03300420041025

NASAL congestion is a common problem of infants. There are many causes of this condition: congenital abnormalities, trauma, infections, environmental irritants or allergens, foreign bodies, and intranasal drug use. Although nasal congestion is not usually considered an urgent or emergency situation, it may become catastrophic in an obligate nose breather. Recently an infant came to our emergency department with acute nasal obstruction from the use of hypertonic saline nose drops.

Report of a Case  A 34-day-old girl was brought to the emergency department with nasal congestion and severe respiratory distress. The mother had taken the baby to another hospital for a runny nose and nasal congestion two days previously. The physician at the clinic had instructed her to use a vaporizer and "salt solution" nose drops every four hours. During the next 36 hours, the infant's condition improved; however, she then became congested again, with the development of intermittent, gasping