Lung Abscess Remains a Life-Threatening Condition in Pediatrics – A Case Report

Abstract

Pulmonary abscess or lung abscess is a lung infection which destroys the lung parenchyma leading to cavitations and central necrosis in localised areas formed by thick-walled purulent material. It can be primary or secondary. Lung abscesses can occur at any age, but it seems that paediatric pulmonary abscess morbidity is lower than in adults. We present the case of a one year and 5-month-old male child admitted to our clinic for fever, loss of appetite and an overall altered general status. Laboratory tests revealed elevated inflammatory biomarkers, leukocytosis with neutrophilia, anaemia, thrombocytosis, low serum iron concentration and increased lactate dehydrogenase level. Despite wide-spectrum antibiotic therapy, the patient’s progress remained poor after seven days of treatment and a CT scan established the diagnosis of a large lung abscess. Despite changing the antibiotic therapy, surgical intervention was eventually needed. There was a slow but steady improvment and eventually, the patient was discharged after approximately five weeks.

Lung Abscess - the answer is in the chest radiograph

“…1,2,3 It can be classified as primary, if it occurs in a previously healthy individual, or secondary, if there is an underlying or predisposing disorder, such as congenital lung disorders and immunodeficiencies. 1,2,4 A primary immunodeficiency (PID) screening (which included complete blood count and measurements of antibody production toward immunizations, serum immunoglobulin levels, total serum hemolytic complement assay and oxidative burst in neutrophils) was performed. IgA deficiency is the most common PID and often presents with recurrent sinopulmonary infections, but according to European Society for Immunodeficiencies (ESID) new criteria, diagnosis should only be considered at an age older than 4 years.…”

“…7,8 Chest radiography usually establishes the diagnosis and CT scan is used in selected cases, to further define the PEDIATRIC ONCALL JOURNAL characteristics of a lesion. 4 Empirical treatment consists of parenteral antibiotics against the most common agents (namely a third-generation cephalosporin and clindamycin). A surgical approach is reserved for those who are refractory to medical therapy.…”

Case Report of an Indian Immunocompetent Toddler With Lung Abscess

“…Pulmonary abscess is also complication of pneumonia or as a hematogenous seedin from any other body site .Lung abscess in children i extremely rare and is d e c re a s i n g d u e t o s i g n i f i c a n p h a r m a c o l o g i c a l advances. [3] Immunodeficienc syndromes or immunosuppressive states caused by vira infection, systemic disorders, and neurologic disorders ar all risk factors for aspiration lung disease. [4] Commo symptoms include fever, cough and emesis where as othe symptoms observed are tachypnoea, dyspnoea, chest pain sputum production, weight loss or haemoptysis.…”