Near-Fatal Lung Injury with Rapid-Onset Bronchiectasis Caused by Traditional Fumigation Therapy on the French Island of Mayotte

摘要

Outside of warfare, almost all reported episodes of severe acute inhalational lung injury have resulted from accidental exposures or rescue attempts. We report a near-fatal episode of profound airway and lung parenchymal injury resulting from fumigation therapy administered by a practitioner of traditional medicine. The patient described in this report lived in the French department of Mayotte, an island located in the Indian Ocean midway between the African continent and Madagascar. Mayotte is a part of the archipelago of Comoros. This island was colonized by France in 1841. However, the local culture is still mostly influenced by African and Arabic traditions, including the practice of herbal medicine. Fumigation therapy, the inhalation of steam raised by boiling water containing medicinal substances, is commonly practiced on the island (, 2). A traditional healer administered fumigation steam to our patient. Because of rapid, profound, and sustained respiratory failure, she required venovenous extracorporeal membrane oxygenation (ECMO) and ultimately underwent lung transplant. Informed consent to publish this report was obtained from the patient and from the patient's mother.