Lung abscess versus necrotizing pneumonia

Implications for interventional therapy

Fredric A. Hoffer, David A. Bloom, Andrew Colin, Steven J. Fishman

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Objective. To assess and contrast the role of interventional therapy for two types of cavitating pneumonias: lung abscess and necrotizing pneumonia. Materials and methods. We retrospectively reviewed the imaging, interventional therapy, and outcome of 14 children seen between February 1987 and January 1996 with lung abscess and 9 with necrotizing pneumonia. All children were treated with antibiotics prior to intervention. Pulmonary parenchymal fluid was percutaneously aspirated from ten lung abscesses and three necrotizing pneumonias. Percutaneous catheters drained five lung abscesses, Pleural drainage was performed for three lung abscesses and eight necrotizing pneumonias. Results. All 14 children with lung abscesses had positive Gram stains of the pulmonary fluid; 13 cultures were positive. All 14 defervesced within 48 h of intervention. None developed a bronchopleural fistula. All nine necrotizing pneumonias were presumed to be sequelae of prior pneumonia. Streptococcus pneumoniae was the only organism as documented by pleural fluid latex fixation in three patients, gram stain in two, and culture in only one. Seven of these children developed pneumatoceles, five developed bronchopleural fistulae, and three required long-term chest tubes for persistent pneumothoraces. Conclusion. Aggressive interventional therapy can be diagnostic and therapeutic in the infected lung abscess. Interventional therapy can be harmful in postinfectious necrotizing pneumonia.

Original languageEnglish
Pages (from-to)87-91
Number of pages5
JournalPediatric Radiology
Volume29
Issue number2
DOIs
StatePublished - Feb 1 1999
Externally publishedYes

Fingerprint

Lung Abscess
Therapeutics
Fistula
Pneumonia
Chest Tubes
Lung
Latex
Pneumothorax
Streptococcus pneumoniae
Necrotizing Pneumonia
Drainage
Catheters
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology

Cite this

Lung abscess versus necrotizing pneumonia : Implications for interventional therapy. / Hoffer, Fredric A.; Bloom, David A.; Colin, Andrew; Fishman, Steven J.

In: Pediatric Radiology, Vol. 29, No. 2, 01.02.1999, p. 87-91.

Research output: Contribution to journalArticle

Hoffer, Fredric A. ; Bloom, David A. ; Colin, Andrew ; Fishman, Steven J. / Lung abscess versus necrotizing pneumonia : Implications for interventional therapy. In: Pediatric Radiology. 1999 ; Vol. 29, No. 2. pp. 87-91.
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