Abstract
Pneumatocele formation is a known complication of pneumonia. Very rarely, they may increase markedly in size, causing cardiorespiratory compromise. Many organisms have been implicated in the pathogenesis of this disease; however, this is the first report of tension pneumatocele resulting from Enterobacter gergoviae pneumonia. We report a case of a 3-month-old Nigerian male child who developed two massive tension pneumatoceles while on treatment for postpneumonic empyema due to Enterobacter gergoviae pneumonia. Tube thoracostomy directed into both pneumatocele resulted in complete resolution and recovery. Enterobacter gergoviae is a relevant human pathogen, capable of causing complicated pneumonia with fatal outcome if not properly managed. In developing countries where state-of the-art radiological facilities and expertise for prompt thoracic intervention are lacking, there is still room for nonoperative management of tension pneumatocele especially in very ill children.
Highlights
Pneumatoceles are thin walled air-filled pulmonary cysts which develop as a complication of pneumonia
We report the case of a 3-month-old male who presented with cough, catarrh, difficulty in breathing, and high-grade, continuous fever of one week duration
Left tube thoracostomy was inserted into the left pleural space
Summary
Pneumatoceles are thin walled air-filled pulmonary cysts which develop as a complication of pneumonia. They can result secondary to trauma and positive pressure ventilation. Postpneumonic pneumatocele may result from rupture of bronchiolar walls due to necrosis causing formation of air corridors and subsequent accumulation of air between the visceral pleura and parenchyma resulting in subpleural pneumatocele [1]. Expanding pneumatocele may result from a check-valve action at the site of rupture [2]. Spontaneous resolution of pneumatocele usually occurs after a few weeks alongside the pneumonic process; in rare cases, it is complicated by dramatic presentation of tension with cardiorespiratory compromise. To the best of our knowledge, this is the first report implicating Enterobacter gergoviae pneumonia as a cause of tension pneumatocele
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