Between scylla and charybdis: a bleomycin-exposed patient with Cohen syndrome.

[cohen syndrome]

Chemotherapy with bleomycin may cause a syndrome of pulmonary sensitivity to supranormal inspired oxygen concentrations that persists for an unknown period of time after exposure . We present a mentally retarded adolescent patient in whom supranormal inspired oxygen was temporarily necessary to manage her difficult airway . Subsequently her pulmonary function deteriorated acutely and , after intermittent stabilization , irreversibly . In this case , bleomycin exposure may have played a pivotal role in modulating minor insults to trigger fatal acute respiratory distress syndrome (ARDS ).