The value and safety of percutaneous lung aspiration for children with serious pulmonary infections.

It is often difficult to establish the etiology of pulmonary infections in children. The diagnostic value and safety of percutaneous needle aspiration of the lung were investigated in 98 children who were suspected of having a bacterial pulmonary infection and who were seriously ill or had failed to respond to apparently adequate empiric antimicrobial therapy. The etiology of the pulmonary infection was established in 60 patients (61%); in the remaining 38 cases (39%) no bacterial microorganisms were recovered from the lung aspirate. Twenty-four (40%) patients in whom the pathogen(s) were identified were already receiving empiric antimicrobial therapy, and in 18 (66%) the original therapeutic regimen had to be changed to optimally treat the isolated microorganism(s). A total of 11 complications occurred in 10 children (10%): 9 pneumothoraces and two instances of mild, self-limited hemoptysis. Six of the pneumothoraces (66%) required treatment by either a thoracostomy and chest-tube or simple percutaneous aspiration. There were no deaths related to the procedures. It was concluded that percutaneous needle aspiration of the lung in children is a potentially useful and reasonably safe technique for the diagnosis of pulmonary infection in carefully selected cases when an exact etiologic diagnosis is needed.