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We describe a healthy 7-month-old female infant who developed spontaneous pneumomediastinum (PM) and subcutaneous emphysema after traumatic nasopharyngeal suctioning (NPS) while hospitalised for respiratory syncytial virus bronchiolitis. To the best of our knowledge, this is the first reported case of pulmonary air leak syndrome associated with traumatic NPS in a healthy infant affected by bronchiolitis. Although NPS is currently the mainstay of treatment in patients admitted with bronchiolitis in the USA, currently there are minimal data regarding the safety and effectiveness of the procedure in patients with bronchiolitis. Physicians should consider the possibility of pulmonary air leak as a complication of NPS and have high suspicion in a decompensating infant after suctioning who is afflicted with bronchiolitis.

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