Hydropneumothorax in Children: A Rare Complication of a Bacterial Pneumonia

Abstract

Hydropneumothorax is an uncommon presentation of a complicated pneumonia, and very few cases in the pediatric population have been reported. This is a case of a 5-month-old patient who presented to the emergency department (ED) with a three-day history of fever, diarrhea, and respiratory distress. His initial assessment suggested a lower respiratory tract infection and because of his respiratory distress and hypoxia a chest X-ray was performed. Other clinical information and radiologic studies will be discussed further, but his chest X-ray suggested a right-sided hydropneumothorax secondary to a complicated pneumonia. He completed 12 days of IV antibiotic treatment and required a chest tube for drainage. Patient was discharged home with a full recovery.

Hydropneumothorax as a complication of necrotizing pneumonia in a young girl

“…While rare, it has been associated with malignancy, infection, chest trauma, rheumatologic diseases that affect lung parenchyma, following chest tube placement, and after a thoracentesis. 1 As seen in our case, patients can develop hydropneumothorax due to BPF secondary to a complicated pneumonia. To the authors' knowledge, necrotizing pneumonia with secondary bronchopleural fistula and hydropneumothorax is such a rare entity that an incidence has not been reported.…”

“…Hydropneumothorax occurs when free fluid and air enters the pleural space. While rare, it has been associated with malignancy, infection, chest trauma, rheumatologic diseases that affect lung parenchyma, following chest tube placement, and after a thoracentesis . As seen in our case, patients can develop hydropneumothorax due to BPF secondary to a complicated pneumonia.…”

“…Initial management should include assessing the airway and breathing while placing cardiac monitors to determine the need for immediate stabilization. Distinguishing a hydropneumothorax from a simple pleural effusion is necessary because treatment of hydropneumothorax frequently requires placement of two chest tubes, one within the fluid and one to remove the air . Surgical management is an option for BPF in pediatric empyema and necrotizing pneumonia.…”

“…Distinguishing a hydropneumothorax from a simple pleural effusion is necessary because treatment of hydropneumothorax frequently requires placement of two chest tubes, one within the fluid and one to remove the air. 1 Surgical management is an option for BPF in pediatric empyema and necrotizing pneumonia. A retrospective study found that early surgery featuring limited decortication and insertion of the serratus anterior muscle digitation flap to be safe and avoid morbidity associated with conservative management and necrotic lung resection surgery.…”

Perawatan Diagnostik dan Konservatif Hidropneumotorax karena Tuberkulosis pada Anak Laki-Laki Berusia 17 Tahun

“…HIV juga cukup memberikan peran penting dalam meningkatkan risiko terjadinya reaktivasi infeksi tuberkulosis laten yang mengakibatkan timbulnya infeksi paru yang progresif dan reinfeksi. [2,7,8] Gejala klinis tuberkulosis paru diklasifikasikan menjadi dua golongan, yaitu gejala lokal dan gejala sistemik. Bila organ yang terkena adalah paru, maka gejala lokal ialah gejala respiratori (gejala lokal sesuai dengan organ yang terlibat).…”