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A 10-year retrospective review of pediatric lung abscesses from a single center
Kavi Madhani1, Eric McGrath2, Lokesh Guglani3
1Department of Pediatrics, Division of General Pediatrics, Children's Hospital of Michigan, Detroit, MI 48201, USA.
Insights
Most pediatric lung abscesses resolve with medical therapy alone. Prolonged fever and larger abscess size may indicate a need for surgery in children with lung abscess.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
Background:
- Limited data exists on treatment response and outcomes for pediatric lung abscesses.
- Lung abscesses in children can be primary or secondary conditions.
Purpose of the Study:
- To characterize the clinical and microbiologic profiles of pediatric lung abscess patients.
- To compare treatment outcomes between medical therapy and combined medical-surgical therapy.
Main Methods:
- Retrospective review of pediatric patients (≤ 18 years) treated for lung abscess from 2004-2014.
- Patients were categorized into medical therapy alone or medical plus surgical intervention groups.
Main Results:
- 39 patients included; 30 received medical therapy, 9 required surgery.
- Common symptoms: fever, cough, emesis. Common comorbidities: respiratory and neurologic disorders.
- Staphylococcus aureus was the most frequent pathogen; ceftriaxone and clindamycin were common antibiotics. Fever duration and abscess size predicted surgical need.
Conclusions:
- Pediatric lung abscess is often manageable with medical therapy alone.
- Prolonged fever and larger abscess size are potential indicators for surgical intervention.
- Prolonged ceftriaxone and clindamycin therapy showed good clinical response.
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.
