Severe necrotizing pneumonia complicated by empyema in a neonate

Zapata, Henry A.; Wahba, Andrew

doi:10.1016/j.rmcr.2020.101248

Cited by 5 publications

(12 citation statements)

References 17 publications

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“…Furthermore, the patient suddenly developed signs of severe respiratory distress, without prodromal symptoms, so the baby was intubated at admission. This rapid progression of the disease and bad clinical condition at admission are unique from the other reviewed cases [2][3][4][5] . In few case reports of empyema, neonates had stable vital signs so all the imaging studies could be completely done [3][4][5] .…”

Section: Discussionmentioning

confidence: 81%

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Open pleural decortication in a 12-day-old neonate with empyema thoracis

et al. 2023

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Introduction. Empyema thoracis, defined as the accumulation of pus in the pleural space, is rare in neonatal population. There are limited data reported in the medical literature and there are still no treatment guidelines available for this age. Case report. We present a healthy term 12-day-old neonate with sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA) and pneumonia associated with advanced stage empyema. The child was admitted to our hospital with a few-hours history of difficulty breathing and lethargy. At the admission, the child was cyanotic with desaturation, in severe respiratory distress, so it was intubated and started mechanical ventilation. Imaging tests were performed in emergency, therefore chest computed tomography (CT) scan was done without contrast. Suspected congenital pulmonary airway malformation (CPAM) with trapped air collections, significant mediastinal shift on CT scan and deterioration of the patient?s condition indicated urgent surgery. Intraoperatively, the diagnosis of stage 2 empyema was established, and decortication of thickened parietal and visceral pleura was performed. Afterwards the baby showed quick and progressive clinical improvement. Conclusion. The diagnosis and management of empyema in neonates may be a challenging one, especially in the case of unremarkably history, fulminant and rapid progression of the disease and incomplete imaging tests.

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Section: Discussionmentioning

confidence: 81%

“…This rapid progression of the disease and bad clinical condition at admission are unique from the other reviewed cases [2][3][4][5] . In few case reports of empyema, neonates had stable vital signs so all the imaging studies could be completely done [3][4][5] .…”

Section: Discussionmentioning

confidence: 81%

Open pleural decortication in a 12-day-old neonate with empyema thoracis

et al. 2023

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“…Therapy should be targeted for Staphylococcus aureus and Streptococcus pneumoniae , the most prevalent bacteria affecting children 3. For Panton–Valentine leukocidin–positive or suspected MRSA, targeted toxin therapy of clindamycin and/or linezolid are recommended 2,14. Clindamycin and linezolid are capable of inhibiting bacterial production of toxins including Panton–Valentine leukocidin.…”

Section: Conservative Managementmentioning

confidence: 99%

“…However, the childhood incidence of necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) has increased from 4.5% to 9% during 2009-2011. 2 A standard management approach has not been established because of the rarity of MRSA pneumatoceles in the neonatal population. Multiple different treatment modalities for all populations are found in the current literature; however, no one treatment stands out as superior.…”

mentioning

confidence: 99%

“…Infections such as pneumonia can cause pneumatoceles; the incidence of infectious pneumatoceles is even more difficult to find in the literature. However, the childhood incidence of necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) has increased from 4.5% to 9% during 2009-2011 2. A standard management approach has not been established because of the rarity of MRSA pneumatoceles in the neonatal population.…”

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confidence: 99%

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Methicillin-Resistant Staphylococcus aureus Pneumatoceles in a Neonate With Sotos Syndrome

Perdue

Newberry

2023

Advances in Neonatal Care

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Background: Necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus can lead to the formation of pneumatoceles in the lungs. Standard treatment guidelines are not available due to the rarity of pneumatoceles in neonates. Clinical Findings: Baby H. required prolonged respiratory support and supplemental oxygen to maintain appropriate oxygen saturation parameters for infants more than 34 weeks' gestation corrected. He was found to have multiple pneumatoceles in both lungs on different radiological modalities. Primary Diagnosis: Baby H. was a former 32.2-week gestation male infant diagnosed with pneumonia caused by necrotizing methicillin-resistant Staphylococcus aureus leading to pneumatocele formation in both lungs. Interventions: Baby H. was managed with aggressive antibiotic therapy and then was conservatively managed until he received a tracheostomy tube on day of life (DOL) 75 to prepare for discharge home. Outcomes: Baby H. was discharged from the neonatal intensive care unit (NICU) on DOL 113 with a tracheostomy tube for prolonged mechanical ventilatory support and a gastrostomy tube for nutrition. Numerous follow-up appointments with specialists have occurred since discharge. Practice Recommendations: While methicillin-resistant Staphylococcus aureus pneumatoceles are uncommon in the NICU setting, it is important for neonatal care providers to be aware of the causes and treatment choices currently available. Although conservative therapy is commonly utilized, it is important that nurses learn other available management strategies such as the ones highlighted in this article to best advocate for their patients.

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Empyema thoracic in a neonate co-infected with SARS-CoV-2 and staphylococcus arouse successfully treated with fibrinolysis: a brief report

Sabzevari,

Sinaei,

Gholami

et al. 2023

BMC Pediatr

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Background Empyema as a rare cause of respiratory distress in neonatal period has not yet been reported after Corona virus disease 2019 (COVID-19) and even rarely in the context of bacterial infections is age group. Case Presentation The first neonate of quadruplets, resulting from Cesarean-Section of a 30-year-old mother without a history of previous illness, born at 34 weeks of gestation with a birth weight of 1600 gram. All four newborns were hospitalized; while the first one underwent nasal continuous positive airway pressure (N-CPAP) with a positive end-expiratory pressure of 6 and fractional inspired oxygen of 0.6, due to respiratory distress, noting a respiratory score of five out of 12.She was resuscitated one hour later due to bradycardia and underwent ventilator support. She received a single dose of pulmonary surfactant, intravenous paracetamol, and phenobarbital due to respiratory distress syndrome, Pectus Ductus Arteriosus, and unilateral clonic movements, respectively. In the lack of positive blood culture, she extubated two days later and breast-feeding was started. On day eight, she underwent high flow nasal cannula. On day 12, she suddenly developed respiratory distress, mottling, and abdominal distension, leading to N-CPAP and re-evaluation. The nasopharyngeal sampling for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) real time Polymerase chain reaction and the blood culture for staphylococcus aurous became positive. A large volume pleural effusion including septa and loculation in right hemi-thorax on chest computerized tomography scan and ultrasound was seen, necessitating to thoracotomy, which was not possible due to her general condition. Remdesivir was started and antibiotics changed to a more broad-spectrum coverage. Chest tube was inserted and Alteplase was injected for three consecutive days with beneficial effects. She had no problem for six-month follow up. Conclusion This was a case of empyema thoracic in the context of SARS-CoV-2 and Staphylococcus arouses co-infection. In our experience, it can be treated by chest drainage and fibrinolysis in neonatal period.

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Severe necrotizing pneumonia complicated by empyema in a neonate

Cited by 5 publications

References 17 publications

Open pleural decortication in a 12-day-old neonate with empyema thoracis

Open pleural decortication in a 12-day-old neonate with empyema thoracis

Methicillin-Resistant Staphylococcus aureus Pneumatoceles in a Neonate With Sotos Syndrome

Empyema thoracic in a neonate co-infected with SARS-CoV-2 and staphylococcus arouse successfully treated with fibrinolysis: a brief report

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