Imaging of cavitary necrosis in complicated childhood pneumonia

Article Article scientifique Article Imaging of cavitary necrosis in complicated childhood pneumonia eng 2002 author Hodina M author Hanquinet Sylviane 133458 author Cotting Jacques Alain 545097 author Schnyder Philippe 77877 author Gudinchet F 391-396 10.1007/s003300101008 11870440 0938-7994 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. Child, Preschool Female Humans Lung/radiography Male Necrosis Pneumonia/radiography Pneumonia, Pneumococcal/radiography Radiography, Thoracic Tomography, X-Ray Computed Dewey 616.0757 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 62 Département de radiologie et informatique médicale 227 false 504 Radiologie neuro-diagnostique et neuro-interventionnelle en pédiatrie 842 European radiology 12 2 54e578ab-5f64-48b5-9cf5-c16cb7ab332d Article (Published version) Restricted 391-396.pdf 829577 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

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Imaging of cavitary necrosis in complicated childhood pneumonia	European radiology			2002	569	0

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Schnyder, Philippe