Diagnostic and Therapeutic Approach in Pediatric Pulmonary Abscess: Two Cases and Literature Review
Abstract
:1. Introduction
1.1. Definition
1.2. Classification
1.3. Etiology and Pathogenesis
1.4. Clinical Features
1.5. Diagnostic Evaluation
1.6. Management
1.7. Conservative Management
1.8. Surgical Treatment
1.9. Evolution, Complication, and Prognosis
1.9.1. Case 1
1.9.2. Case 2
2. Discussions
3. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Patradoon-Ho, P.; Fitzgerald, D.A. Lung abscess in children. Paediatr. Respir. Rev. 2007, 8, 77–84. [Google Scholar] [CrossRef] [PubMed]
- De Benedictis, F.M.; Kerem, E.; Chang, A.B.; Colin, A.A.; Zar, H.J.; Bush, A. Complicated pneumonia in children. Lancet 2020, 396, 786–798. [Google Scholar] [CrossRef] [PubMed]
- Yousef, L.; Yousef, A.; Al-Shamrani, A. Lung Abscess Case Series and Review of the Literature. Children 2022, 9, 1047. [Google Scholar] [CrossRef] [PubMed]
- Kuhajda, I.; Zarogoulidis, K.; Tsirgogianni, K.; Tsavlis, D.; Kioumis, I.; Kosmidis, C.; Tsakiridis, K.; Mpakas, A.; Zarogoulidis, P.; Zissimopoulos, A.; et al. Lung abscess-etiology, diagnostic and treatment options. Ann. Transl. Med. 2015, 3, 183. [Google Scholar] [PubMed]
- Roik, D.; Mosior, T.; Sopyło, B.; Małdyk, J.; Brzewski, M. Abscess mimicking lung metastasis in a 10-year-old boy—Case report. Pol. J. Radiol. 2010, 75, 55–57. [Google Scholar]
- Vlahova, A.; Antonova, Z.; Rangelov, E.; Kartulev, N.; Oparanova, V.; Gabrovska, N.; Spasova, A.; Velizarova, S.; Shivachev, H. Surgical Treatment of Lung Abscess Due to an Awn Aspiration in a 9-Year-Old Child: A Case Report. Children 2023, 10, 910. [Google Scholar] [CrossRef] [PubMed]
- Puligandla, P.S.; Laberge, J.-M. Respiratory infections: Pneumonia, lung abscess, and empyema. Semin. Pediatr. Surg. 2008, 17, 42–52. [Google Scholar] [CrossRef] [PubMed]
- Nicolini, A.; Cilloniz, C.; Senarega, R.; Ferraioli, G.; Barlascini, C. Lung Abscess Due to Streptococcus pneumoniae: A Case Series and Brief Review of the Literature. Adv. Respir. Med. 2014, 82, 276–285. [Google Scholar] [CrossRef]
- Takayanagi, N.; Kagiyama, N.; Ishiguro, T.; Tokunaga, D.; Sugita, Y. Etiology and Outcome of Community-Acquired Lung Abscess. Respiration 2010, 80, 98–105. [Google Scholar] [CrossRef]
- Madhani, K.; McGrath, E.; Guglani, L. A 10-year retrospective review of pediatric lung abscesses from a single center. Ann. Thorac. Med. 2016, 11, 191–196. [Google Scholar] [CrossRef]
- Redding, G.J.; Carter, E.R. Chronic Suppurative Lung Disease in Children: Definition and Spectrum of Disease. Front. Pediatr. 2017, 5, 30. [Google Scholar] [CrossRef] [PubMed]
- Loukeri, A.A.; Kampolis, C.F.; Tomos, P.; Papapetrou, D.; Pantazopoulos, I.; Tzagkaraki, A.; Veldekis, D.; Lolis, N. Diagnosis, treatment and prognosis of lung abscess. Pneumon 2015, 28, 54. [Google Scholar]
- Choi, M.S.; Chun, J.H.; Lee, K.S.; Rha, Y.H.; Choi, S.H. Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals. Korean J. Pediatr. 2015, 58, 478. [Google Scholar] [CrossRef]
- Breuer, O.; Picard, E.; Benabu, N.; Erlichman, I.; Reiter, J.; Tsabari, R.; Shoseyov, D.; Kerem, E.; Cohen-Cymberknoh, M. Predictors of Prolonged Hospitalizations in Pediatric Complicated Pneumonia. Chest 2018, 153, 172–180. [Google Scholar] [CrossRef] [PubMed]
- Yen, C.-C.; Tang, R.-B.; Chen, S.-J.; Chin, T. Pediatric lung abscess: A retrospective review of 23 cases. J. Microbiol. Immunol. Infect. 2004, 37, 45–49. [Google Scholar] [PubMed]
- Bennett, J.E.; Dolin, R.; Blaser, M.J. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases: 2-Volume Set; Elsevier Health Sciences: Amsterdam, The Netherlands, 2019; ISBN 978-0-323-55027-7. [Google Scholar]
- Ionescu, M.D.; Popescu, N.A.; Stănescu, D.; Enculescu, A.; Bălgrădean, M.; Căpitănescu, G.M.; Bumbăcea, D. The Challenging Diagnosis of Interstitial Lung Disease in Children—One Case Report and Literature Review. J. Clin. Med. 2022, 11, 6736. [Google Scholar] [CrossRef] [PubMed]
- Eslamy, H.K.; Newman, B. Pneumonia in Normal and Immunocompromised Children: An Overview and Update. Radiol. Clin. N. Am. 2011, 49, 895–920. [Google Scholar] [CrossRef] [PubMed]
- Mukae, H.; Noguchi, S.; Naito, K.; Kawanami, T.; Yamasaki, K.; Fukuda, K.; Akata, K.; Fukuda, Y.; Kido, T.; Ishimoto, H.; et al. The Importance of Obligate Anaerobes and the Streptococcus anginosus Group in Pulmonary Abscess: A Clone Library Analysis Using Bronchoalveolar Lavage Fluid. Respiration 2016, 92, 80–89. [Google Scholar] [CrossRef] [PubMed]
- Klein, J.S.; Schultz, S.; Heffner, J.E. Interventional radiology of the chest: Image-guided percutaneous drainage of pleural effusions, lung abscess, and pneumothorax. Am. J. Roentgenol. 1995, 164, 581–588. [Google Scholar] [CrossRef]
- Quick, R.D.; Auth, M.J.; Fernandez, M.; Meyer, T.; Merkel, K.G.; Thoreson, L.M.; Hauger, S.B. Decreasing Exposure to Radiation, Surgical Risk, and Costs for Pediatric Complicated Pneumonia: A Guideline Evaluation. Hosp. Pediatr. 2017, 7, 287–293. [Google Scholar] [CrossRef]
- Odev, K.; Guler, İ.; Altinok, T.; Pekcan, S.; Batur, A.; Ozbiner, H. Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation. J. Clin. Imaging Sci. 2013, 3, 60. [Google Scholar] [CrossRef] [PubMed]
- Nagasawa, K.K.; Johnson, S.M. Thoracoscopic treatment of pediatric lung abscesses. J. Pediatr. Surg. 2010, 45, 574–578. [Google Scholar] [CrossRef] [PubMed]
- Shah, S.S.; Srivastava, R.; Wu, S.; Colvin, J.D.; Williams, D.J.; Rangel, S.J.; Samady, W.; Rao, S.; Miller, C.; Cross, C.; et al. Intravenous Versus Oral Antibiotics for Postdischarge Treatment of Complicated Pneumonia. Pediatrics 2016, 138, e20161692. [Google Scholar] [CrossRef] [PubMed]
- De Benedictis, F.M.; Carloni, I. Management of necrotizing pneumonia in children: Time for a patient-oriented approach. Pediatr. Pulmonol. 2019, 54, 1351–1353. [Google Scholar] [CrossRef] [PubMed]
- Reimel, B.A.; Krishnadasen, B.; Cuschieri, J.; Klein, M.B.; Gross, J.; Karmy-Jones, R. Surgical Management of Acute Necrotizing Lung Infections. Can. Respir. J. 2006, 13, 369–373. [Google Scholar] [CrossRef] [PubMed]
- Sueyoshi, R.; Koga, H.; Suzuki, K.; Miyano, G.; Okawada, M.; Doi, T.; Lane, G.J.; Yamataka, A. Surgical intervention for congenital pulmonary airway malformation (CPAM) patients with preoperative pneumonia and abscess formation: “open versus thoracoscopic lobectomy”. Pediatr. Surg. Int. 2016, 32, 347–351. [Google Scholar] [CrossRef] [PubMed]
- Al-Salem, A.H.; Ali, E.A. Computed tomography-guided percutaneous needle aspiration of lung abscesses in neonates and children. Pediatr. Surg. Int. 1997, 12, 417–419. [Google Scholar] [CrossRef] [PubMed]
- Saito, T.; Matano, M.; Kodachi, T.; Fukui, K.; Monden, Y.; Fuchimoto, Y. Pulmonary abscess in an infant treated with ultrasound-guided drainage. J. Pediatr. Surg. Case Rep. 2020, 60, 101549. [Google Scholar] [CrossRef]
- Chiang, P.-C.; Lin, C.-Y.; Hsu, Y.-C.; Huang, L.-T.; Chung, T.-J.; Liu, Y.-S.; Chang, C.-C. Early drainage reduces the length of hospital stay in patients with lung abscess. Front. Med. 2023, 10, 1206419. [Google Scholar] [CrossRef] [PubMed]
- Hogan, M.J.; Coley, B.D. Interventional radiology treatment of empyema and lung abscesses. Paediatr. Respir. Rev. 2008, 9, 77–84. [Google Scholar] [CrossRef] [PubMed]
- Wali, S.O.; Samman, Y.S.; Abdelaziz, M.; Shugaeri, A. Percutaneous Drainage of Pyogenic Lung Abscess. Scand. J. Infect. Dis. 2002, 34, 673–679. [Google Scholar] [CrossRef]
- Macedo, M.; Meyer, K.F.; Oliveira, T.C.M. Pneumonia necrosante em crianças submetidas à toracoscopia por empiema pleural: Incidência, tratamento e evolução clínica. J. Bras. Pneumol. 2010, 36, 301–305. [Google Scholar] [CrossRef] [PubMed]
- Stockmann, C.; Ampofo, K.; Pavia, A.T.; Byington, C.L.; Sheng, X.; Greene, T.H.; Korgenski, E.K.; Hersh, A.L. Comparative Effectiveness of Oral Versus Outpatient Parenteral Antibiotic Therapy for Empyema. Hosp. Pediatr. 2015, 5, 605–612. [Google Scholar] [CrossRef] [PubMed]
- Masarweh, K.; Gur, M.; Toukan, Y.; Bar-Yoseph, R.; Kassis, I.; Gut, G.; Hakim, F.; Nir, V.; Bentur, L. Factors associated with complicated pneumonia in children. Pediatr. Pulmonol. 2021, 56, 2700–2706. [Google Scholar] [CrossRef]
- Cowles, R.A.; Lelli, J.L.; Takayasu, J.; Coran, A.G. Lung resection in infants and children with pulmonary infections refractory to medical therapy. J. Pediatr. Surg. 2002, 37, 643–647. [Google Scholar] [CrossRef] [PubMed]
- Masters, I.B.; Isles, A.F.; Grimwood, K. Necrotizing pneumonia: An emerging problem in children? Pneumonia 2017, 9, 11. [Google Scholar] [CrossRef] [PubMed]
- Zar, H.J.; Andronikou, S.; Nicol, M.P. Advances in the diagnosis of pneumonia in children. BMJ 2017, 358, j2739. [Google Scholar] [CrossRef]
- Eren, Ş.; Balci, A.E.; Dikici, B.; Doblan, M.; Eren, M.N. Foreign body aspiration in children: Experience of 1160 cases. Ann. Trop. Paediatr. 2003, 23, 31–37. [Google Scholar] [CrossRef]
- Nasir, Z.M.; Subha, S.T. A Five-Year Review on Pediatric Foreign Body Aspiration. Int. Arch. Otorhinolaryngol. 2021, 25, e193–e199. [Google Scholar] [CrossRef] [PubMed]
- Zaki, H.A.; Albaroudi, B.; Shaban, E.E.; Shaban, A.; Elgassim, M.; Almarri, N.D.; Basharat, K.; Azad, A.M. Advancement in pleura effusion diagnosis: A systematic review and meta-analysis of point-of-care ultrasound versus radiographic thoracic imaging. Ultrasound J. 2024, 16, 3. [Google Scholar] [CrossRef] [PubMed]
- Aryal, K.; Regmi, P.R.; Adhikari, G.; Bhhattarai, U.; Sedhain, S.P. Congenital pulmonary airway malformation (CPAM): A case report and review of the literature. Radiol. Case Rep. 2023, 18, 3483–3486. [Google Scholar] [CrossRef] [PubMed]
- Anadol, D.; Göçmen, A.; Kiper, N.; Özçelik, U. Hydatid disease in childhood: A retrospective analysis of 376 cases. Pediatr. Pulmonol. 1998, 26, 190–196. [Google Scholar] [CrossRef]
- Lees, E.A.; Ives, A.; Fowler, D.; Lakhoo, K.; Grant, D.; Kelly, D.; Paulus, S.; Segal, S.; Gilchrist, J.J.; Kew, A.; et al. Pulmonary Cystic Echinococcosis in a Child Presenting in the United Kingdom with Fever and Chest Pain: A Brief Report and Discussion on Management. Pediatr. Infect. Dis. J. 2023, 42, e343–e345. [Google Scholar] [CrossRef] [PubMed]
- Thadchanamoorthy, V.; Dayasiri, K. Pulmonary tuberculosis presenting as lung abscess in a 10-month-Old infant. Respir. Med. Case Rep. 2020, 31, 101229. [Google Scholar] [CrossRef] [PubMed]
- Yalaki, Z.; Taşar, M.A.; Yıldız, E.; Zengin, T.; Çiftçi, E.; Dallar, Y.B. Primary cavitary tuberculosis in an infant. Türk Pediatri Arş. 2018, 53, 189–192. [Google Scholar] [CrossRef] [PubMed]
On Admission | 7th Day of Treatment | 10th Day of Treatment | Normal Range | |
---|---|---|---|---|
Complete blood count | ||||
Leucocytes | 19,600/μL | 17,950/μL | 15,400/μL | 6–17 × 103/μL |
Lymphocytes | 4400/μL | 3100/μL | 4300/μL | 3–9.5 × 103/μL |
Monocytes | 1160/μL | 1050/μL | 1180/μL | 0–1 × 103/μL |
Neutrophils | 9900/μL | 8800/μL | 8600/μL | 1.5–8.5 × 103/μL |
Platelets | 621,000/μL | 520,000/μL | 560,000/μL | 150,000–450,000/μL |
Hemoglobin | 9.5 g/dL | 10.2g/dL | 10.8 g/dL | 11–14 g/dL |
MCV | 70/fL | 72.1/fL | 73/fL | 73–89/fL |
MCHC | 29.6 g/dL | 31 g/dL | 32.9 g/dL | 32–37 g/dL |
Inflammatory markers | ||||
CRP | 120.4 mg/L | 80 mg/L | 63 mg/L | 0–5 mg/L |
Procalcitonin | 5.9 ng/mL | 0.08 ng/mL | <0.05 ng/mL | |
LDH | 238 U/L | 120–300 U/L | ||
Coagulation | ||||
PT | 15.9 s | 11.3–15.6 s | ||
APTT | 32.5 s | 24–37 s | ||
INR | 1.19 | 0.84–1.2 | ||
Liver function | ||||
AST | 29.4 U/L | 2–59 U/L | ||
ALT | 16.2 U/L | 2–29 U/L | ||
Kidney function | ||||
Creatinine | 0.19 mg/dL | <0.47 mg/dL | ||
BUN | 9.6 mg/dL | <41 mg/dL | ||
Serum iron | 10.7 μg/dL | 29–91 μg/dL | ||
Serum protein | 7.06 g/dL | 5.6–7.5 g/dL |
On Admission | 7th Day of Treatment | 15th Day of Treatment | Normal Range | |
---|---|---|---|---|
Complete blood count | ||||
Leucocytes | 17,300/μL | 17,900/μL | 19,900/μL | 4.5–13 × 103/μL |
Lymphocytes | 740/μL | 1100/μL | 1900/μL | 1.5–6.5 × 103/μL |
Monocytes | 1250/μL | 900/μL | 2000/μL | 0–1 × 103/μL |
Neutrophils | 15,250/μL | 16,500/μL | 15,500/μL | 1.8–8.0 × 103/μL |
Eosinophils | 600/μL | 500/μL | 300/μL | 0–0.7 × 103/μL |
Platelets | 352,000/μL | 420.000/μL | 350,000/μL | 150,000–450,000/μL |
Hemoglobin | 14 g/dL | 13.6 g/dL | 13.7 g/dL | 11.7–16.6 g/dL |
Inflammatory markers | ||||
ESR | 70 mm/1 h | 2–15 mm/1 h | ||
CRP | 244 mg/L | 201 mg/L | 191 mg/L | 0–5 mg/L |
Procalcitonin | 7 ng/mL | 1.5 ng/mL | <0.05 ng/mL | |
LDH | 630 U/L | 120–300 U/L | ||
Fibrinogen | 961 mg/dL | 160–390 mg/dL | ||
Coagulation | ||||
PT | 16.2 s | 16.3 s | 11.3–15.6 s | |
APTT | 27.5 s | 28 s | 24–37 s | |
INR | 1.24 | 1.25 | 0.84–1.2 | |
Liver function | ||||
AST | 42 U/L | 19 U/L | 2–40 U/L | |
ALT | 67 U/L | 27 U/L | 2–41 U/L | |
Kidney function | ||||
Creatinine | 0.72 mg/dL | 0.7 mg/dL | <1.2 mg/dL | |
BUN | 25 mg/dL | 43 mg/dL | <41 mg/dL |
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Costin, M.; Cinteză, E.; Marcu, V.; Pavelescu, M.L.; Cherecheș-Panța, P.; Bălănescu, J.S.; Slăvulete, R.E.; Roxana, T.; Ionescu, M.D. Diagnostic and Therapeutic Approach in Pediatric Pulmonary Abscess: Two Cases and Literature Review. J. Clin. Med. 2024, 13, 7790. https://doi.org/10.3390/jcm13247790
Costin M, Cinteză E, Marcu V, Pavelescu ML, Cherecheș-Panța P, Bălănescu JS, Slăvulete RE, Roxana T, Ionescu MD. Diagnostic and Therapeutic Approach in Pediatric Pulmonary Abscess: Two Cases and Literature Review. Journal of Clinical Medicine. 2024; 13(24):7790. https://doi.org/10.3390/jcm13247790
Chicago/Turabian StyleCostin, Mariana, Eliza Cinteză, Veronica Marcu, Mirela Luminița Pavelescu, Paraschiva Cherecheș-Panța, Julia Susanne Bălănescu, Ramona Elena Slăvulete, Taraș Roxana, and Marcela Daniela Ionescu. 2024. "Diagnostic and Therapeutic Approach in Pediatric Pulmonary Abscess: Two Cases and Literature Review" Journal of Clinical Medicine 13, no. 24: 7790. https://doi.org/10.3390/jcm13247790
APA StyleCostin, M., Cinteză, E., Marcu, V., Pavelescu, M. L., Cherecheș-Panța, P., Bălănescu, J. S., Slăvulete, R. E., Roxana, T., & Ionescu, M. D. (2024). Diagnostic and Therapeutic Approach in Pediatric Pulmonary Abscess: Two Cases and Literature Review. Journal of Clinical Medicine, 13(24), 7790. https://doi.org/10.3390/jcm13247790