According to a recent article in the International Business Times, a twenty-two-month-old girl living in Odisha, India was diagnosed with pulmonary alveolar proteinosis.

The disease causes respiration difficulties due to fragments of calcium phosphate accumulating in small air sacs in the lungs (alveoli). The child was unable to cough up the material in her lungs. Some patients in these situations face life-threatening issues.

In such cases, the standard procedure is to “wash” the lungs with a solution of water and salt called saline. The girl is the youngest person in India to undergo the procedure.

And Now COVID-19

The patient contracted but recovered from COVID-19 in June together with other members of her family. But one month later she showed signs of a fever and had difficulty breathing. She was taken to several hospitals, but her condition kept deteriorating.

Finally, she was admitted to AIIMS Bhubaneswar’s pediatrics department. By then her breathing was extremely irregular and she was dependent upon twenty liters of oxygen daily. The doctors agreed that the only possible treatment was to wash her lungs with saline. The procedure is called Whole Lung Lavage (WLL). The excess material is initially “washed” from one lung. The other lung is hooked up to a machine that supplies pure oxygen. Then the procedure is reversed.

After the first procedure, she was washed again but this time without the need for ECMO support. Thankfully there was an improvement in her condition, and she was sent home with several liters of oxygen.

Pediatrician Dr. Krishna Gulla said that the doctors anticipate the need to wash the child’s lungs on a regular basis, but they hope that as her condition improves, she will not require ECMO.

The doctors are uncertain whether her disease was in any way connected to COVID-19.