Imaging of cavitary necrosis in complicated childhood pneumonia.

Details

Ressource 1Download: serval:BIB_15980795771F.P001 (810.13 [Ko])
State: Public
Version: author
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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_15980795771F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Imaging of cavitary necrosis in complicated childhood pneumonia.
Journal
European radiology
Author(s)
Hodina M., Hanquinet S., Cotting J., Schnyder P., Gudinchet F.
ISSN
0938-7994
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
12
Number
2
Pages
391-6
Language
english
Notes
Publication types: Journal Article - Publication Status: ppublish
Abstract
The aim of this study was to illustrate the chest radiographs (CR) and CT imaging features and sequential findings of cavitary necrosis in complicated childhood pneumonia. Among 30 children admitted in the Pediatric Intensive Care Unit for persistent or progressive pneumonia, respiratory distress or sepsis despite adequate antibiotic therapy, a study group of 9 children (5 girls and 4 boys; mean age 4 years) who had the radiographic features and CT criteria for cavitary necrosis complicated pneumonia was identified. The pathogens identified were Streptococcus pneumoniae( n=4), Aspergillus( n=2), Legionella( n=1), and Staphylococcus aureus( n=1). Sequential CR and CT scans were retrospectively reviewed. Follow-up CR and CT were evaluated for persistent abnormalities. Chest radiographs showed consolidations in 8 of the 9 patients. On CT examination, cavitary necrosis was localized to 1 lobe in 2 patients and 7 patients showed multilobar or bilateral areas of cavitary necrosis. In 3 patients of 9, the cavitary necrosis was initially shown on CT and visualization by CR was delayed by a time span varying from 5 to 9 days. In all patients with cavities, a mean number of five cavities were seen on antero-posterior CR, contrasting with the multiple cavities seen on CT. Parapneumonic effusions were shown by CR in 3 patients and in 5 patients by CT. Bronchopleural fistulae were demonstrated by CT alone ( n=3). No purulent pericarditis was demonstrated. The CT scan displayed persistent residual pneumatoceles of the left lower lobe in 2 patients. Computed tomography is able to define a more specific pattern of abnormalities than conventional CR in children with necrotizing pneumonia and allows an earlier diagnosis of this rapidly progressing condition. Lung necrosis and cavitation may also be associated with Aspergillus or Legionella pneumonia in the pediatric population.
Keywords
Child, Preschool, Female, Humans, Lung, Male, Necrosis, Pneumonia, Pneumonia, Pneumococcal, Radiography, Thoracic, Tomography, X-Ray Computed
Pubmed
Web of science
Open Access
Yes
Create date
08/04/2008 14:38
Last modification date
01/10/2019 6:16
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