Wojsyk-Banaszak I, Krenke K, Jończyk-Potoczna K, Ksepko K, Wielebska A, Mikoś M, Bręborowicz A
Department of Pulmonology, Pediatric Allergy and Clinical Immunology, Poznań University of Medical Sciences, Poznań, Poland.
Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
J Infect Chemother. 2018 May;24(5):376-382. doi: 10.1016/j.jiac.2017.12.020. Epub 2018 Feb 15.
The aim of the study was to describe the epidemiology and clinical characteristic of children hospitalized with pneumonia complicated by lung abscess, as well as to evaluate the long-term sequelae of the disease.
A retrospective review of medical records of all patients treated for pulmonary abscess in two tertiary centers was undertaken. Pulmonary function tests and lung ultrasound were performed at a follow-up.
During the study period, 5151 children with pneumonia were admitted, and 49 (0.95%) cases were complicated with lung abscess. In 38 (77.5%) patients, lung abscess was treated solely with antibiotics, and in nine cases (16.3%) surgically. In 21 (51.21%) children complete radiological regression was documented. The mean time for radiological abnormalities regression was 84.14 ± 51.57 days, regardless of the treatment mode. Fifteen patients were followed up at 61.6 ± 28.3 months after discharge. Lung ultrasound revealed minor residual abnormalities: pleural thickening, subpleural consolidations and line B artefacts in 11 (73.3%) children. Pulmonary function tests results were abnormal in eight (53.3%) patients, the most frequent abnormality being hyperinflation. We did not find a restrictive disorder in any of the children. There were no deaths in our study.
Lung abscess is a rare but severe complication of pneumonia in children. Most children recover uneventfully with no significant long-term pulmonary sequelae.
本研究旨在描述因肺炎并发肺脓肿住院儿童的流行病学特征和临床特点，并评估该疾病的长期后遗症。
对两家三级医疗中心所有接受肺脓肿治疗的患者病历进行回顾性分析。随访期间进行肺功能测试和肺部超声检查。
研究期间，5151例肺炎患儿入院，其中49例（0.95%）并发肺脓肿。38例（77.5%）患者仅接受抗生素治疗，9例（16.3%）接受手术治疗。21例（51.21%）患儿影像学表现完全恢复。无论治疗方式如何，影像学异常恢复的平均时间为84.14±51.57天。15例患者出院后61.6±28.3个月进行随访。肺部超声显示有轻微残留异常：11例（73.3%）患儿存在胸膜增厚、胸膜下实变和B线伪像。8例（53.3%）患者肺功能测试结果异常，最常见的异常为过度充气。我们未在任何患儿中发现限制性疾病。本研究中无死亡病例。
肺脓肿是儿童肺炎罕见但严重的并发症。大多数患儿恢复顺利，无明显的长期肺部后遗症。
