Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone ...Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone becomes inadequate. Chest CT is the gold standard diagnostic imaging tool, however, in a resource-limited context, it may not be performed. Chest ultrasound can therefore be an alternative for drainage and intermittent follow-up of complicated parapneumonic pleural effusions. We report the case of a 4-year-old child who presented with cough, breathing difficulties and fever for over two weeks and in whom an initial chest X-ray revealed a left hemithorax white-out with an air-fluid level. Chest ultrasound revealed a left pleuropulmonary massive fluid collection with an encysted empyema. It also allowed ultrasound-guided pleural effusion drainage of a fibrino-purulent liquid which tested positive for Kocuria kristinae, a bacterium sensitive to gentamycin, vancomycin, norfloxacin and clindamycin. The next follow-up ultrasound checks showed improvement and the control chest X-ray performed one month later demonstrated pulmonary functional recovery. This case highlights the importance of ultrasound in the management and follow-up of this chest pathology in resource-limited settings.展开更多
Mycoplasma pneumonia is a common community-acquired pneumonia （CAP） in Asia. Children suffering from M. pneumoniae tend to progress quickly and develop severe pneumonia with a poor prognosis.（1） Effective manageme...Mycoplasma pneumonia is a common community-acquired pneumonia （CAP） in Asia. Children suffering from M. pneumoniae tend to progress quickly and develop severe pneumonia with a poor prognosis.（1） Effective management of M. pneumoniae infections include macrolides, tetracyclines or fluoroquinolones, however, antibiotic resistance may lead to unsatisfied clinical outcome. Chinese medicine （CM） is widely used in China and some Asian countries, which have good efficacy in the treatment of M. pneumoniae, especially for severe M. Pneumonia infection.（2） It has obvious advantages in terms of fever reduction and appetite improvement. Here we report a case of a child diagnosed with severe pneumonia who received antibiotics for 20 days but with suboptimal result, however, he experienced an optimal response to CM.展开更多
文摘Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone becomes inadequate. Chest CT is the gold standard diagnostic imaging tool, however, in a resource-limited context, it may not be performed. Chest ultrasound can therefore be an alternative for drainage and intermittent follow-up of complicated parapneumonic pleural effusions. We report the case of a 4-year-old child who presented with cough, breathing difficulties and fever for over two weeks and in whom an initial chest X-ray revealed a left hemithorax white-out with an air-fluid level. Chest ultrasound revealed a left pleuropulmonary massive fluid collection with an encysted empyema. It also allowed ultrasound-guided pleural effusion drainage of a fibrino-purulent liquid which tested positive for Kocuria kristinae, a bacterium sensitive to gentamycin, vancomycin, norfloxacin and clindamycin. The next follow-up ultrasound checks showed improvement and the control chest X-ray performed one month later demonstrated pulmonary functional recovery. This case highlights the importance of ultrasound in the management and follow-up of this chest pathology in resource-limited settings.
文摘Mycoplasma pneumonia is a common community-acquired pneumonia （CAP） in Asia. Children suffering from M. pneumoniae tend to progress quickly and develop severe pneumonia with a poor prognosis.（1） Effective management of M. pneumoniae infections include macrolides, tetracyclines or fluoroquinolones, however, antibiotic resistance may lead to unsatisfied clinical outcome. Chinese medicine （CM） is widely used in China and some Asian countries, which have good efficacy in the treatment of M. pneumoniae, especially for severe M. Pneumonia infection.（2） It has obvious advantages in terms of fever reduction and appetite improvement. Here we report a case of a child diagnosed with severe pneumonia who received antibiotics for 20 days but with suboptimal result, however, he experienced an optimal response to CM.
