Complicated pneumonias with empyema and/or pneumatocele in children

Abstract

To investigate the incidence, procedure type, characteristics of pleural fluid and pneumatoceles, and evolution of pneumonia complicated with empyema and/or pneumatoceles. Review of 394 pediatric pneumonia in patients at São Paulo State University Hospital during 2 years. We studied those with complications such as pleural effusion and pneumatocele. There were 121 (30.71%) with complications such as pleural effusion and pneumatocele; these were significantly higher in infants. One hundred and six children were needle aspirated, of these 78 underwent drainage, and 15 observation only. From the drained, seven needed thoracotomy or pleurostomy. Fluid was purulent in 50%, and pneumatoceles were seen in 33 cases (8.3%) with spontaneous involution in 28 (85%). Pleural fluid culture was negative in 51% cases; in positive cultures, Streptococcus pneumoniae was the most common agent. Complicated pneumonia incidence was higher in the second year of life and more than 70% occurred before 4 years of age. Closed thoracic drainage was effective in over 90%. Large effusions and mediastinal deviations were submitted to more aggressive procedures. Pneumatoceles predominated in the under 3s and were generally evident in the first chest X-ray. Most cases had spontaneous pneumatocele involution, and in almost half the cases were still present at drain tube removal.

Fatores associados às complicações em crianças pré-escolares com pneumonia adquirida na comunidade

“…The most common complication was pleural effusion, a finding that is consistent with those of other authors. (12,14,17,18) complicated CAP group presented with such complications at admission.…”

“…(6,10,11) In Brazil, 373,622 children ≤ 14 years of age were hospitalized for pneumonia in 2004; of those children, 48% were in the 1-4 year age bracket. (12) In this year age bracket, bacterial pneumonia gains importance, being associated with an increased risk of complications, such as pleural effusion and pulmonary parenchymal injury. (13,14) These complications are the main determinants of clinical worsening and risk of death in children under 5 years of age.…”

Pulmonary Tuberculosis with Hematogenous Spread Associated with Hemaphagocytic Syndrome and Multiple Pulmonary Pneumatoceles

“…The association with TB disease is unusual and has seldom been described [4][5][6][7][8][9], even more rarely in childhood [10][11][12][13]. Pathogenesis of these lesions remains unclear.…”

Neumonía complicada con neumatocele en un lactante, caso clínico

“…En la mayoría de los casos los neumatoceles son asintomáticos y se resuelven espontáneamente en un promedio de 6 semanas, sin dejar secuelas y sin necesidad de resolución quirúrgica. Sin embargo, se han descrito casos en que este proceso es más largo y la regresión de la lesión puede demorar meses o más en desaparecer 4,9,10 . Así es como en esta paciente se observó una resolución total después de casi 5 meses de evolución.…”