Kumar K G R, Bakhshi Sameer, Samantaray J C, Banerjee U, Arya L S
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Pediatr. 2004 Feb;71(2):129-32. doi: 10.1007/BF02723093.
Transthoracic lung aspiration was performed in 30 episodes of pneumonia in 27 children with malignancy on chemotherapy to assess etiology of pulmonary infections. Total of 22 organisms were isolated in 16/30 (53.3%) episodes. No acid fast bacilli or Pneumocystis carinii were seen. Organisms grown by blood culture correlated with that of lung puncture in 5 episodes, while throat culture and nasopharyngeal organisms correlated with that of lung puncture on one occasion each. Organisms isolated in 8/18 episodes (44.4%) of antemorten transthoracic aspiration included: Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Streptococcus faecalis and Diphtheroids. In 3/18 episodes, lung puncture results altered treatment and thus resulted in survival of the patients. Only one minor complication occurred in this study--pneumothorax that resolved spontaneously. Thus, transthoracic lung puncture is an useful and safe procedure in immunocompromised patients with pneumonia who do not respond to initial broad spectrum antibiotics.
对27例接受化疗的恶性肿瘤患儿的30次肺炎发作进行了经胸肺穿刺，以评估肺部感染的病因。在16/30（53.3%）次发作中总共分离出22种微生物。未发现抗酸杆菌或卡氏肺孢子虫。血培养生长的微生物与肺穿刺的微生物在5次发作中相关，而咽喉培养和鼻咽部微生物分别在一次发作中与肺穿刺的微生物相关。在18次生前经胸穿刺的8/18（44.4%）次发作中分离出的微生物包括：铜绿假单胞菌、肺炎克雷伯菌、大肠杆菌、粪肠球菌和类白喉杆菌。在3/18次发作中，肺穿刺结果改变了治疗方案，从而使患者存活。本研究仅发生1例轻微并发症——气胸，自行缓解。因此，经胸肺穿刺对于对初始广谱抗生素无反应的免疫功能低下的肺炎患者是一种有用且安全的操作。
