Patradoon-Ho Patrick, Fitzgerald Dominic A
Fairfield Hospital, Sydney, NSW, Australia.
Paediatr Respir Rev. 2007 Mar;8(1):77-84. doi: 10.1016/j.prrv.2006.10.002. Epub 2007 Feb 14.
Lung abscess is an uncommon paediatric problem, with a paucity of quality data on the subject in the medical literature. Although the condition has for many years been managed successfully with prolonged courses of intravenous antibiotics, the evolution of interventional radiology has seen the use of percutaneously placed 'pigtail catheters' inserted under ultrasound and computed tomography guidance become the mainstay of therapy where such resources are available. This has been suggested to result in a more rapid defervescence of fever and symptoms, shorter periods of intravenous antibiotics and a decreased length of inpatient care. More invasive procedures, aspiration and drainage, together with improved microbiological diagnostic techniques, including polymerase chain reaction testing, has increased the yield of pathogens identified from abscess fluid samples. Culture results will guide treatment, especially for immunocompromised subjects who may develop a lung abscess as a complication of their underlying condition. The predominant pathogens isolated from primary lung abscesses in children include streptococcal species, Staphylococcus aureus and Klebsiella pneumoniae. Children with a lung abscess, both primary and secondary, have a significantly better prognosis than adults with the same condition.
肺脓肿是一种罕见的儿科疾病，医学文献中关于该主题的高质量数据匮乏。尽管多年来通过长期静脉使用抗生素已成功治疗该疾病，但随着介入放射学的发展，在有相关资源的情况下，在超声和计算机断层扫描引导下经皮插入“猪尾导管”已成为主要治疗方法。这被认为可使发热和症状更快消退，静脉使用抗生素的时间缩短，住院时间缩短。更具侵入性的操作、抽吸和引流，以及包括聚合酶链反应检测在内的改进的微生物诊断技术，提高了从脓肿液样本中鉴定出的病原体的检出率。培养结果将指导治疗，特别是对于可能因基础疾病而并发肺脓肿的免疫功能低下患者。儿童原发性肺脓肿中分离出的主要病原体包括链球菌属、金黄色葡萄球菌和肺炎克雷伯菌。患有肺脓肿的儿童，无论是原发性还是继发性，其预后都明显好于患有相同疾病的成人。
