Is abdominal pain after an injury just an injury? Case report of rare aspiration pneumonia with lung gangrene and peritoneal response in a 5-year-old child
Authors:
Ján Hrubovčák 1; Ubomír Tulinský 1; Peter Ihnát 1; Petr Jelínek 1; Ivana Slívová 1; Marcel Mitták 1; Jan Roman 1; Jan Stránský 2
Authors‘ workplace:
Chirurgická klinika LF UO a FN Ostrava
1; Klinika úrazové chirurgie a ortopedie LF UO a FN Ostrava
2
Published in:
Čas. Lék. čes. 2023; 162: 160-163
Category:
Case report
Overview
Although pneumonia presents a relatively common diagnosis, it does not always present with classic clinical symptoms, nor does it follow a regular course without complications. The presented case describes a rare case of aspiration necrotizing pneumonia, which despite intensive therapy, progressed to lung gangrene and required a lung lobectomy. Another peculiarity is that the correct diagnosis was established only after the onset of abdominal pain, surprisingly by a trauma surgeon. This case emphasizes the necessity of a thorough general examination and draws attention to a rare, but conservatively intractable necrotizing pneumonia complicated by lung gangrene.
Keywords:
acute abdomen – Pediatrics – Abdominal pain – Lobectomy – necrotizing pneumonia
Sources
- Tsai Y-F, Ku Y-H. Necrotizing pneumonia: a rare complication of pneumonia requiring special consideration. Curr Opin Pulm Med 2012; 18: 246–252.
- Masters IB, Isles AF, Grimwood K. Necrotizing pneumonia: an emerging problem in children? Pneumonia (Nathan) 2017; 9: 11.
- Kerem E, Bar Ziv Y, Rudenski B et al. Bacteremic necrotizing pneumococcal pneumonia in children. Am J Respir Crit Care Med 1994; 149: 242–244.
- Griffin MR, Zhu Y, Moore MR et al. U.S. hospitalizations for pneumonia after a decade of pneumococcal vaccination. N Engl J Med 2013; 369: 155–163.
- Sawicki GS, Lu FL, Valim C et al. Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J 2008; 31: 1285–1291
- Strachan R, Jaffe A. Assessment of the burden of paediatric empyema in Australia. J Paediatr Child Health 2009; 45: 431–436.
- Lemaître C, Angoulvant F, Gabor F et al. Necrotizing pneumonia in children. Report of 41 cases between 2006 and 2011 in a French tertiary care center. Pediatr Infect Dis J 2013; 32: 1146–1149.
- Byington CL, Hulten KG, Ampofo K et al. Molecular epidemiology of pediatric pneumococcal empyema from 2001 to 2007 in Utah. J Clin Microbiol 2010; 48: 520–525.
- Tan TQ. Serious and invasive pediatric pneumococcal disease: epidemiology and vaccine impact in the USA. Expert Rev Anti Infect Ther 2010; 8: 117–125.
- Hodina M, Hanquinet S, Cotting J et al. Imaging of cavitary necrosis in complicated childhood pneumonia. Eur Radiol 2002; 12: 391–396.
- Hoffer FA, Bloom DA, Colin AA, Fishman SJ. Lung abscess versus necrotizing pneumonia: implications for interventional therapy. Pediatr Radiol 1999; 29: 87–91.
- Lai SH, Wong KS, Liao SL. Value of lung ultrasonography in the diagnosis and outcome prediction of pediatric community-acquired pneumonia with necrotizing change. PLoS One 2015; 10: e0130082.
- Paradisi F, Corti G, Messeri D. Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics. Med Clin North Am 2001; 85: 1–17.
- Wang Y, Xu D, Li S, Chen Z. Mycoplasma pneumoniae-associated necrotizing pneumonitis in children. Pediatr Int 2012; 54: 293–297.
- Fretzayas A, Moustaki M, Alexopoulou E et al. Clinical notations on bacteraemic cavitating pneumococcal pneumonia in nonvaccinated immunocompetent children. J Trop Pediatr 2009; 55: 257–261.
- Macedo M, Meyer KF, Oliveira TCM. Necrotizing pneumonia in children submitted to thoracoscopy due to pleural empyema: incidence, treatment and clinical evolution. J Bras Pneumol 2010; 36: 301–305.
- Wong KS, Chiu CH, Yeow KM et al. Necrotising pneumonitis in children. Eur J Pediatr 2000; 159: 684–688.
- Krenke K, Sanocki M, Urbankowska E et al. Necrotizing pneumonia and its complications in children. Adv Exp Med Biol 2015; 12: 9–17.
- Jester I, Nijran A, Singh M, Parikh DH. Surgical management of bronchopleural fistula in pediatric empyema and necrotizing pneumonia: efficacy of the serratus anterior muscle digitation flap. J Pediatr Surg 2012; 47: 1358–1362.
- Pabary R, Balbour-Lynn IM. Complicated pneumonia in children. Breathe 2013; 9: 211–222.
- Loizzi M, De Palma A, Pagliarulo V et al. Pulmonary infections of surgical interest in childhood. Thorac Surg Clin 2012; 22: 387–401.
- Hacimustafaoglu M, Celebi S, Sarimehmet H et al. Necrotizing pneumonia in children. Acta Paediatr 2004; 93: 1172–1177.
- Janapatla R-P, Hsu M-H, Hsieh Y-C et al. Necrotizing pneumonia caused by nanC-carrying serotypes is associated with pneumococcal haemolytic uraemic syndrome in children. Clin Microbiol Infect 2013; 19: 480–486.
- Al-Saleh S, Grasemann H, Cox P. Necrotizing pneumonia complicated by early and late pneumatoceles. Can Respir J 2008; 15: 129–132.
- Demirel N, Quizon A, Belteton de Leon EL et al. On the nature of pleural involvement in necrotizing pneumonia: a report of two cases of life threatening late complications. Pediatr Pulmonol 2014; 49: E90–E95.
- Atkinson AL, Canterino J. Foreign body aspiration in pregnancy. Case Rep Obstet Gynecol 2012; 2012: 890106.
- Tintinalli JE. Emergency Medicine: A Comprehensive Study Guide. McGraw-Hill, New York, 2010: 480.
- Gauss H. Abdominal pain in pneumonia. Am J Dig Dis 1946; 13: 73–77.
- Tsalkidis A, Gardikis S, Cassimos D et al. Acute abdomen in children due to extra-abdominal causes. Pediatr Int 2008; 50: 315–318.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
2023 Issue 4
Most read in this issue
- Ethical aspects of tissue and organ transplantation
- Prevence a programy prevence karcinomu plic
- Therapeutic drug monitoring in psychiatry
- Is abdominal pain after an injury just an injury? Case report of rare aspiration pneumonia with lung gangrene and peritoneal response in a 5-year-old child