Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy
Empyema necessitatis (EN) is a rare complication of empyema in which the pleural infection spreads outside the pleural space. Lower airway infections are common among children with cerebral palsy (CP). Although harmless to healthy individuals, Pseudomonas aeruginosa can cause invasive infections, in...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-01-01
|
| Series: | Journal of Infection and Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034119301819 |
| _version_ | 1818237325794082816 |
|---|---|
| author | Akihiro Nishimura Hiroshi Yamaguchi Yusuke Ito Shoichi Tokumoto Daisaku Toyoshima Masashi Kasai Azusa Maruyama |
| author_facet | Akihiro Nishimura Hiroshi Yamaguchi Yusuke Ito Shoichi Tokumoto Daisaku Toyoshima Masashi Kasai Azusa Maruyama |
| author_sort | Akihiro Nishimura |
| collection | DOAJ |
| description | Empyema necessitatis (EN) is a rare complication of empyema in which the pleural infection spreads outside the pleural space. Lower airway infections are common among children with cerebral palsy (CP). Although harmless to healthy individuals, Pseudomonas aeruginosa can cause invasive infections, including CP, in immunocompromised hosts. Mycobacterium tuberculosis and Actinomyces spp. have been reported as common causative organisms of EN. However, EN caused by P. aeruginosa has never been reported. We report the case of an 8-year-old girl with CP without tracheotomy who was admitted to our hospital with complaints of fever and increased epileptic seizures. First, she was diagnosed with pneumonia and treated with antibiotics. However, seven days after admission, a palpable mobile mass overlying the lower part of the shoulder blade was noticed. Enhanced magnetic resonance imaging revealed broad high signal area on T2-weighted and diffusion-weighted images, indicating empyema of the left lower lung that had penetrated the pleural wall and spread to the subcutaneous area of the left back. Thus, she was diagnosed with EN. Twelve days after admission, P. aeruginosa was detected from the pus culture. Patients with CP who have chronic lung diseases, such as pneumonia, atelectasis, or empyema, may need careful follow up. Keywords: Debridement, Drainage, Pneumonia, Soft tissue infection |
| first_indexed | 2024-12-12T12:23:58Z |
| format | Article |
| id | doaj.art-89b497e85af44fd8b5aab1ce2e69da73 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-12-12T12:23:58Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-89b497e85af44fd8b5aab1ce2e69da732022-12-22T00:24:36ZengElsevierJournal of Infection and Public Health1876-03412020-01-01131140142Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsyAkihiro Nishimura0Hiroshi Yamaguchi1Yusuke Ito2Shoichi Tokumoto3Daisaku Toyoshima4Masashi Kasai5Azusa Maruyama6Department of Neurology, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, JapanDepartment of Neurology, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, Japan; Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, Japan; Corresponding author at: Department of Neurology, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojimaminamimachi, Chuo-Ku, Kobe, Hyogo 650-0047 Japan.Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, JapanDepartment of Neurology, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, Japan; Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, JapanDepartment of Neurology, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, JapanDivision of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, JapanDepartment of Neurology, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, JapanEmpyema necessitatis (EN) is a rare complication of empyema in which the pleural infection spreads outside the pleural space. Lower airway infections are common among children with cerebral palsy (CP). Although harmless to healthy individuals, Pseudomonas aeruginosa can cause invasive infections, including CP, in immunocompromised hosts. Mycobacterium tuberculosis and Actinomyces spp. have been reported as common causative organisms of EN. However, EN caused by P. aeruginosa has never been reported. We report the case of an 8-year-old girl with CP without tracheotomy who was admitted to our hospital with complaints of fever and increased epileptic seizures. First, she was diagnosed with pneumonia and treated with antibiotics. However, seven days after admission, a palpable mobile mass overlying the lower part of the shoulder blade was noticed. Enhanced magnetic resonance imaging revealed broad high signal area on T2-weighted and diffusion-weighted images, indicating empyema of the left lower lung that had penetrated the pleural wall and spread to the subcutaneous area of the left back. Thus, she was diagnosed with EN. Twelve days after admission, P. aeruginosa was detected from the pus culture. Patients with CP who have chronic lung diseases, such as pneumonia, atelectasis, or empyema, may need careful follow up. Keywords: Debridement, Drainage, Pneumonia, Soft tissue infectionhttp://www.sciencedirect.com/science/article/pii/S1876034119301819 |
| spellingShingle | Akihiro Nishimura Hiroshi Yamaguchi Yusuke Ito Shoichi Tokumoto Daisaku Toyoshima Masashi Kasai Azusa Maruyama Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy Journal of Infection and Public Health |
| title | Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy |
| title_full | Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy |
| title_fullStr | Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy |
| title_full_unstemmed | Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy |
| title_short | Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy |
| title_sort | empyema necessitatis due to pseudomonas aeruginosa in a child with cerebral palsy |
| url | http://www.sciencedirect.com/science/article/pii/S1876034119301819 |
| work_keys_str_mv | AT akihironishimura empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT hiroshiyamaguchi empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT yusukeito empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT shoichitokumoto empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT daisakutoyoshima empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT masashikasai empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy AT azusamaruyama empyemanecessitatisduetopseudomonasaeruginosainachildwithcerebralpalsy |