Department of Pediatric Pulmonology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, the Netherlands
Correspondence to: Peter Merkus, MD, PhD, Department of Pediatric Pulmonology, Erasmus Medical Centre, Sophia Children’s Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands; e-mail: email@example.com
With interest we read the publication of Picard et al,1 who demonstrated that the prevalence of postbronchoscopic fever in children can be reduced by administration of dexamethasone. The study is well designed, and the results are convincing. We agree that postbronchoscopic fever is uncomfortable, occurs frequently, and sometimes causes distress with parents and physicians. However, one could argue that administration of 0.5 mg/kg of dexamethasone to avoid such distress is not necessary.
In our practice, we instruct parents that they should expect their child to be a little feverish in the 12 to 24 h following bronchoscopy, that this is normal, and that they only should contact a doctor when the fever persists for > 24 h or the child becomes ill. With that policy, parents contacted us in < 1% of cases (> 600 bronchoscopies in 10 years). Two of these patients were thought to have an infection for which antibiotic treatment was started.
Alternatively, one could prescribe oral antipyretics after the procedure if fever occurs, rather than immunosuppressing drugs. There is no proof that immunosuppression prevents any long-term sequelae, and there remains the small risk of bacteremia, especially in patients with chronic lung disease or immunologic disorders.2
The authors have no conflicts of interest to disclose.
Become a CHEST member and receive a FREE subscription as a benefit of membership.
Individuals can purchase this article on ScienceDirect.
Individuals can purchase a subscription to the journal.
Individuals can purchase a subscription to the journal or buy individual articles.
Learn more about membership or Purchase a Full Subscription.
Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited:
Customize your page view by dragging & repositioning the boxes below.
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.