Necrotising pneumonitis in children

Kin Sun Wong, Cheng Hsun Chiu, Kee Min Yeow, Yhu Chering Huang, Hui Ping Liu, Tzou Yien Lin

研究成果: 雜誌貢獻文章同行評審

32 引文 斯高帕斯(Scopus)

摘要

We retrospectively analysed the clinical features and outcome of children under 17 years of age with necrotising pneumonitis (NP). The radiographs and CT scans of the chest of children under 17 years of age between July 1995 and March 1999 who had complicating community-acquired pneumonia were reviewed. CT scans were obtained for persistent fever, respiratory distress and sepsis despite empiric antibiotic therapy and closed tube drainage. A total of 21 children had the radiographic features of NP of whom 11 (52%) patients were successfully managed using antibiotic therapy with or without closed tube drainage. Ten patients required thoracoscopic decortications and/or lysis of pleural adhesions or debridement of empyema due to refractory pleural sepsis, failure of pulmonary re-expansion and persistent air-leaks. The most common pathogens identified were Streptococcus pneumoniae (n = 3), Staphylococcus aureus (n = 2), and Haemophilus infiuenzae type b (n = 2). The days of hospital stay, duration of fever and days of C-reactive protein return to normal were significantly less for the medically versus the surgically treated children (P < 0.05). Conclusion: The clinical course of necrotising pneumonitis in children following complicated pneumonia is often prolonged despite adequate antibiotic therapy. Necrotising pneumonitis with co-existing multiple loculations, pneumothorax/bronchopleural fistula in the empyema and extensive pleural peel are poor prognostic factors for medical therapy. Thoracoscopic removal of loculated empyema lysis of adhesions and/or decortication are effective in relieving tachypnoea, chest pain, and controlling fever and improve the outcome, especially in children with empyema.
原文英語
頁(從 - 到)684-688
頁數5
期刊European Journal of Pediatrics
159
發行號9
DOIs
出版狀態已發佈 - 2000
對外發佈

ASJC Scopus subject areas

  • 兒科、圍產兒和兒童健康

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