Pneumonectomy in a Child with Multilobar Pneumatocele Secondary to Necrotizing Pneumonia: Case Report and Review of the Literature

Overview

Journal Case Rep Pediatr

Publisher Wiley

Specialty Pediatrics

Date 2019 Aug 10

PMID 31396429

Citations 4

Authors

Christopher A Gerdung

B Catherine Ross

Bryan J Dicken

Candice L Bjornson

Affiliations

Soon will be listed here.

Abstract

Background: Community-acquired pneumonia (CAP) is common within pediatrics and contributes disproportionately to morbidity and mortality. Necrotizing pneumonia is a well-documented complication of CAP. It is thought to be caused by necrosis and liquefaction of consolidated lung and can result in damage to lung parenchyma, including pneumatocele development. Management of necrotizing pneumonia with pneumatocele may include hospitalization, intensive care unit admission, and lengthy antibiotic courses. Severe cases may need invasive procedures.

Case Presentation: We present a case of severe necrotizing pneumonia requiring prolonged venovenous extracorporeal membrane oxygenation (V-V ECMO) with development of persistent pneumatoceles, requiring pneumonectomy while on ECMO support to allow for decannulation and extubation.

Conclusions: In critically ill patients with extensive unilateral necrotizing pneumonia with pneumatocele development, surgical intervention can be considered when attempts to wean ventilation have been unsuccessful. This case provides evidence that V-V ECMO and pneumonectomy is a viable salvage therapy in the most critically unwell children.

Citing Articles

Clinical Characteristics of Necrotizing Pneumonia Caused by Different Pathogens.

Luo Y, Wang Y Infect Drug Resist. 2023; 16:3777-3786.

PMID: 37337573 PMC: 10276989. DOI: 10.2147/IDR.S419294.

Pneumatocele formation following COVID-19 pneumonia. Is there a role for surgical intervention?.

McCann C, Shoeib M, Rashid M, Kostoulas N Asian Cardiovasc Thorac Ann. 2021; :2184923211059866.

PMID: 34874785 PMC: 9174975. DOI: 10.1177/02184923211059866.

Early recognition of necrotizing pneumonia in children based on non-contrast-enhanced computed tomography radiomics signatures.

Chen X, Li W, Wang F, He L, Liu E Transl Pediatr. 2021; 10(6):1542-1551.

PMID: 34295769 PMC: 8261593. DOI: 10.21037/tp-20-241.

Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study.

Buonsenso D, Toma P, Scateni S, Curatola A, Morello R, Valentini P Pediatr Radiol. 2020; 50(11):1560-1569.

PMID: 32821992 DOI: 10.1007/s00247-020-04750-w.

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