A 10-year retrospective review of pediatric lung abscesses from a single center

• Authors: Kavi Madhani, Children's Hospital of Michigan; Eric McGrath, Children's Hospital of Michigan; Lokesh Guglani, Emory University
• Journal Title: Annals of Thoracic Medicine
• Volume: Volume 11, Number 3
• Publisher: Medknow Publications | 2016-07-07, Pages 191-196
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.4103/1817-1737.185763
• Subjects: Health Sciences, Immunology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Respiratory System; Cardiovascular System & Cardiology; Abscess; anaerobes; antibiotics; bacterial; empyema; infections; lung; microbiology pediatric; pneumonia; surgery; CHILDREN; INFANTS; RESECTION; DRAINAGE; EMPYEMA; THERAPY; Pediatrics

Abstract

INTRODUCTION: Pediatric lung abscesses can be primary or secondary, and there is limited data regarding response to treatments and patient outcomes. OBJECTIVES: To assess the clinical and microbiologic profile of pediatric patients with lung abscess and assess the differences in outcomes for patients treated with medical therapy or medical plus surgical therapy. METHODS: A retrospective review of all pediatric patients = 18 years of age that were treated as an inpatient for lung abscess between the dates of August 2004 and August 2014 was conducted. Patients were divided into two subgroups based on the need for surgical intervention. RESULTS: A total of 39 patients with lung abscess (30 treated with medical therapy alone, 9 also required surgical interventions) were included. Fever, cough, and emesis were the most common presenting symptoms, and most of the patients had underlying respiratory (31%) or neurologic disorders (15%). Staphylococcus aureus was the most common organism in those that had culture results available, and ceftriaxone with clindamycin was the most common combination of antibiotics used for treatment. Comparison of medical and surgical subgroups identified the duration of fever and abscess size as risk factors for surgical intervention. CONCLUSIONS: Pediatric lung abscesses can be managed with medical therapy alone in most cases. Presence of prolonged duration of fever and larger abscess size may be predictive of the need for surgical intervention. Good clinical response to prolonged therapy with ceftriaxone and clindamycin was noted.