Neumonía complicada con neumatocele en un lactante, caso clínico

Abstract

Introduction: Pneumatocele is an uncommon complication of pneumonia, most often asymptomatic with spontaneous resolution. Case-report: Female infant with an history of right upper lobe pneumonia, an air filled structure was noted in the chest X-ray. Asymptomatic until admitted for a wheezing episode, where an increase in the size of the structure was evidenced. She had clinical and radiological follow-up as recommended in a recent study, observing that 5 months later the cystic image was completely resolved. Discussion: According to criteria from published studies, this case is a non complicated pneumatocele because it was asymptomatic, compromised less than 50% of the hemithorax and no atelectasia, bronchopleural fistula or signs of infection were observed. Non complicated pneumatoceles can be followed up, and complicated can be treated by image guided catheter drainage or surgical resection. In this case, we confirmed spontaneous resolution after clinical and radiological follow-up.

Pneumatocele complicated with bronchopleural fistula and pneumothorax in SARS-CoV2 pneumonia

“…A chest X-ray may be useful for de initial diagnosis, but a CT scan gives the definitive diagnosis and is the gold standard in these cases, since it is the most accurate imaging technique and has the highest sensitivity for pneumatocele identification 5,10 . Moreover, it is also useful for the evaluation of its size, location, and the identification of complications.…”

“…In most cases, pneumatoceles usually appear within the first 2 weeks of pneumonia infection and resolve spontaneously and completely within a few weeks to 6-12 months, especially in children 2,4,5 . However, in some cases, more invasive procedures may be needed, usually a percutaneous placement of a catheter drainage or a chest tube 1,10 , which is connected to negative aspiration until its resolution, like it occurred in the case of our patient.…”

Complicaciones graves de neumonía en lactante mayor, a propósito de un caso

“…8 Durante la evolución de una neumonía no es infrecuente que los niños presenten complicaciones, tales como: derrame pleural paraneumónico, empiema pulmonar, absceso pulmonar, neumonía necrotizante y pioneumotórax. 5,9 En los últimos años se ha evidenciado un aumento del número de hospitalizaciones por neumonía bacteriana y en la prevalencia de complicaciones en niños, sin determinarse aún cuál es la causa de este aumento en las complicaciones. Algunos autores sugieren que pueden deberse al aumento de la resistencia bacteriana sobre todo del neumococo, la presencia de determinados serotipos y la respuesta inflamatoria del huésped a los componentes del agente causal.…”