Abstract
The patient presented at a general hospital with vomiting and a fever of 39°C after receiving dental treatment under ambulatory general anesthesia and returning home without experiencing any problems. At the general hospital, she was diagnosed as having aspiration pneumonia and required medical treatment for 3 days. The patient was a 25-year-old female with Down syndrome who had been scheduled to undergo a dental procedure under ambulatory general anesthesia for the 24th time at our institution. Her body temperature before the general anesthesia was 36.6°C, and she did not have any symptoms. While under the general anesthesia, she did not exhibit a fever or other abnormalities, such as a decrease in Spo2. The treatment and anesthesia procedures were completed in 45 and 75 minutes, respectively. After the general anesthesia, her Spo2 was 96%, her pulse rate was 100 beats/min, and there were no issues with wakefulness. Thus, she was allowed to go home. In the evening, when she was contacted to confirm her physical condition, she was found to be vomiting with a 39°C fever and was thus seen at a nearby general hospital and was diagnosed as having aspiration pneumonia based on chest computed tomography findings and blood test results. During the subsequent 3 days, the patient was treated with antibiotics, and her pneumonia improved. Down syndrome is characterized by impaired swallowing function, weak resistance to infection, and being prone to pneumonia. Moreover, when aspiration pneumonia is mild and still in the early stage, clinical symptoms are less likely to develop and are more likely to be overlooked. Therefore, in patients with Down syndrome, checking for findings of inflammation via auscultation, Spo2, blood tests, and imaging procedures is important. For patients with a high risk of aspiration pneumonia, the prevention of postoperative nausea and vomiting and the administration of antibiotics should be applied on a case-by-case basis.
