Tratamento cirúrgico de pneumonia necrosante: análise de quatro casos

Westphal, Fernando Luíz; Lima, Luiz Carlos de Oliveira; Ferreira, Cyntia Almeida; Carvalho, Maria Auxiliadora De

doi:10.1590/s0102-35862000000100002

Cited by 6 publications

(4 citation statements)

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“…others studies performed: In Taiwan, in five years old, 21 cases of pneumonia necrotizing (6) ; In France, in 6 years old, 41 cases (7) ; In Boston, in 3 years old, 12 cases and in 4 years old, 40 cases (8). At complications and the treatment are consistent with that of other authors (9)(10)(11). Although in case studies there is no can esteem the prevalence of the disease in our country, given the conditions in health of populations the incidence of the pneumonia.…”

Section: Discussionsupporting

confidence: 81%

Profile in Children Interned at the Hospital Pediatric David Bernardino (Angola) With Pneumonia Necrotizing in 2018

Gamboa¹,

Silvestre²,

Cardoso³

et al. 2022

JHS

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Introduction: The pneumonia necrotizing It is one illness defined as consolidation of a pulmonary segment with necrosis in its periphery with multiple cavities, walls thin visible for the Tomography Axial computerized. Objective: To describe the clinical, laboratory and imaging profile of children admitted to the David Bernardino Pediatric Hospital (Angola) with necrotizing pneumonia from February to October 2018. Methodology: Study prospective type series in cases accomplished in 18 children with ages understood in between two months and 14 years old in age. Were analyzed at variables age, sex, vaccination status, nutritional status, socio-economic level of country, disease duration before diagnosis, previous antibiotic therapy and results in exams in diagnosis, treatment, complications and state the exit. Results: The mean age was 39 months. Fever was present in 100% From cases, The difficulty respiratory in 94.4%, malnutrition moderate in 39% and anemia in 50% of cases. The erythrocyte sedimentation rate was in mean of 97 mm Hg in the 1st hour, the number of leukocytes of 36,100/mm3 and the length of stay of 39 days. Streptococcus pneumoniae was isolated in pleural fluid in 16.6% of cases, Staphylococcus aureus and Proteus mirabilis in 11.1% of cases. The most frequent complications were empyema with fistula (77%), empyema without fistula (15.5%) and Pyopneumothorax (7.5%). Conclusion: The diagnosis of necrotizing pneumonia must be considered in children who maintain a fever despite adequate treatment of pneumonia.

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Section: Discussionsupporting

confidence: 81%

Profile in Children Interned at the Hospital Pediatric David Bernardino (Angola) With Pneumonia Necrotizing in 2018

Gamboa¹,

Silvestre²,

Cardoso³

et al. 2022

JHS

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“…In some cases, dire circumstances related to complications of NP call for emergency surgical procedures, despite the high rates of morbidity and mortality associated with such interventions. (18,25) In conclusion, we underscore the idea that, for the early detection of necrosis of the lung parenchyma, axial chest CT should be performed in children with pneumonia who also present with persistent fever, worsening of clinical status, or pleural complications despite the use of appropriate antimicrobial therapy. Once a diagnosis of NP has been confirmed, patients should be evaluated for the possibility of surgical resection of the damaged segment in order to improve the prognosis.…”

Section: Discussionmentioning

confidence: 72%

Tratamento cirúrgico de crianças com pneumonia necrosante

et al. 2010

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Objective: To describe the results of the surgical treatment of children with necrotizing pneumonia. Methods: A retrospective analysis of the medical charts of 20 children diagnosed with necrotizing pneumonia and submitted to surgical treatment between March of 1997 and September of 2008 in the thoracic surgery departments of two hospitals in the city of Manaus, Brazil. We compiled data regarding age, gender, etiologic agent, indications for surgery, type of surgical resection performed, and postoperative complications. Results: The mean age of the patients was 30 months. Of the 20 patients studied, 12 (60%) were female. The most common etiologic agents were Staphylococcus aureus, in 5 patients (25%), and Klebsiella sp., in 2 (10%). The indications for surgery were sepsis, in 16 patients (80%), and bronchopleural fistula, in 4 (20%). The types of surgical procedures performed were lobectomy, in 12 patients (60%), segmentectomy, in 7 (35%), and bilobectomy, in 1 (5%). There were 8 patients (40%) who also underwent decortication. The postoperative complications were as follows: bronchopleural fistula, in 4 patients (20%); empyema, in 1 (5%); pneumatocele, in 1 (5%); and phlebitis of the left arm, in 1 (5%). Four (20%) of the patients died. Conclusions: Surgical resection should be considered in patients with evidence of pulmonary necrosis. Resection is indicated in cases of severe sepsis, high output bronchopleural fistula, or acute respiratory failure that are refractory to clinical treatment.Keywords: Pneumonia; Necrosis; Lung abscess; Empyema, pleural. ResumoObjetivo: Descrever os resultados do tratamento cirúrgico de crianças com pneumonia necrosante. Métodos: Análise retrospectiva dos prontuários de 20 crianças diagnosticadas com pneumonia necrosante e submetidas ao tratamento cirúrgico nos serviços de cirurgia torácica de dois hospitais na cidade de Manaus (AM) entre março de 1997 e setembro de 2008. Dados referentes a idade, sexo, agente etiológico, motivos da indicação cirúrgica, tipo de ressecção cirúrgica realizada e complicações pós-operatórias foram compilados. Resultados: Dos 20 pacientes analisados, 12 (60%) eram do sexo feminino. A média de idade dos pacientes foi de 30 meses. Os agentes etiológicos mais encontrados foram Staphylococcus aureus, em 5 pacientes (25%), e Klebsiella sp., em 2 (10%). Os motivos de indicação cirúrgica foram sepse, em 16 pacientes (80%), e fístula broncopleural, em 4 (20%). Os tipos de procedimentos cirúrgicos realizados foram lobectomia, em 12 pacientes (60%), segmentectomia, em 7 (35%), e bilobectomia, em 1 (5%). Além desses procedimentos, 8 pacientes (40%) foram submetidos à descorticação pulmonar. As complicações pós-operatórias foram as seguintes: fístula broncopleural, em 4 pacientes (20%); empiema, em 1 (5%); pneumatocele, em 1 (5%); e flebite em membro superior esquerdo, em 1 (5%). Quatro pacientes (20%) morreram. Conclusões: Pacientes com evidências de necrose pulmonar devem ser considerados para a ressecção cirúrgica, que está indicada em casos graves de ...

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“…Early identification of this potentially fatal complication is indispensable, since immediate surgical treatment involving resection of the necrotic tissue can improve the prognosis. (30) In conclusion, staphylococcal pneumonia generally presents a variety of clinical findings and a course that ranges from subacute to fulminant. Radiological findings such as cavitation, pleural effusion, bilateral consolidations and rapid radiological progression of pulmonary lesions are common.…”

Section: Discussionmentioning

confidence: 99%