Lung Abscess in Infants and Children

Abstract

We retrospectively reviewed 18 cases of primary lung abscess and 10 cases of secondary lung abscess in infants and children during a 6-year period. Among 18 patients with primary abscesses, nine were boys and nine girls, from 9 months to 20 years old, but only two of 18 were less than 5 years old. Each had a solitary abscess. Location of abscesses included the right lower lobe (8), the right upper lobe (3), the left upper lobe (1), and the left lower lobe (6). One patient had Streptococcus pneumoniae bacteremia. Other bacterial isolates were from the upper respiratory tract and of uncertain significance. All patients recovered, although lobectomy was considered necessary in five patients because of failure to respond to intravenous antibiotic therapy. Secondary lung abscesses occurred in six boys and four girls who were from 2 1/2 months to 13 years old. All 10 had solitary, right-sided lesions, seven in the right lower lobe and three in the right upper lobe. Bacteria of unclear significance were recovered from three of 10 patients, while two had documented gram-negative bacteremia. Three secondary abscess patients underwent lobectomy because of perceived inadequate response to medical therapy, including intravenous antibiotics. Based upon the literature and our experience, therapy for pulmonary abscess should include a parenteral antibiotic with gram-positive activity against both penicillinase-producing Staphylococcus aureus and anaerobes for a minimum of 3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Lung resection in children for infectious pulmonary diseases

“…However, both acute and chronic refractory pulmonary infections do occur. Previous reports have shown that a history of pneumonia is a major risk factor for the development of lung abscess or refractory lung infection [2,5]. Invasive procedures, like bronchoscopy to obtain material for bacteriologic studies, remain controversial.…”

Lung abscess in a child secondary to Mycoplasma pneumoniae infection

“…4 The gold standard medical therapy for lung abscess is administration of empiric parenteral antibiotics with anaerobic bacteria and Gram-positive cocci coverage. 7 Early treatment can prevent further complications and can reduce the chance of obligatory surgical interventions. 7 In children, the role of surgical therapy for lung abscess should be limited only to a minority of patients who are refractory to medical treatment or who develop complications such as bronchopleural fistula.…”

“…7 Early treatment can prevent further complications and can reduce the chance of obligatory surgical interventions. 7 In children, the role of surgical therapy for lung abscess should be limited only to a minority of patients who are refractory to medical treatment or who develop complications such as bronchopleural fistula. 4 Lung abscess in children is a rare complication of M. pneumoniae infection and only four previous cases have been described in the literature.…”

Pediatric Empyema, Lung Abscess, Chylothorax

“…Akciğer apselerinin çoğu, spontan olarak bir bronşa drene olduğu ve kavite temizlendiği için sadece antibiyotik tedavisi ile düzelebilir ve çok az bir kısmı cerrahi drenaj gerektirir (35). Antibiyotik tedavisinde, kültür ve antibiyotik duyarlılık sonuçları tedavinin başarısını etkiler.…”