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Updated: Jul 15, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Successful thoracoscopic treatment of severe bilateral empyema in an infant

Kei Tanaka1, Teruaki Mizobuchi, Taiki Fujiwara

  • 1Department of Chest Surgery, Matsudo City Hospital, 4005 Kamihongo, Matsudo, Chiba, Japan.

General Thoracic and Cardiovascular Surgery
|April 24, 2007
PubMed

Insights

A severe infant case of bilateral pyothorax rapidly progressed after viral influenza, complicated by Staphylococcus aureus pneumonia. Surgical intervention was required for this critical condition, leading to the infant's recovery.

Area of Science:

  • Pediatric Infectious Diseases
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Viral influenza can predispose infants to secondary bacterial infections.
  • Pyothorax, a serious pleural space infection, requires prompt management.
  • Coagulopathy, such as disseminated intravascular coagulation, can complicate severe infections.

Observation:

  • An 11-month-old infant developed rapid bilateral pyothorax following viral influenza.
  • Methicillin-susceptible Staphylococcus aureus (MSSA) pneumonia was identified as the likely secondary bacterial pathogen.
  • The infant developed disseminated intravascular coagulation, indicating a severe systemic inflammatory response.

Findings:

  • Standard treatments including thoracentesis and antibiotics were insufficient to control the pyothorax.
  • Bilateral video-assisted thoracoscopic decortication was successfully performed on hospital day 8.
  • The surgical intervention resulted in excellent lung expansion and clinical recovery.

Implications:

  • This case highlights the potential for rapid deterioration in infants with influenza-associated pyothorax.
  • Video-assisted thoracoscopic surgery may be a crucial treatment option for refractory pyothorax in pediatric patients.
  • Early recognition and aggressive management are vital for improving outcomes in severe pediatric pleural infections.

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