engleski

Right-sided lobar pneumonia complicated by pleural effusion n an eight-year-old boy – Case report

Introduction: Pneumonia is leading cause of death in children in the developing world, causing substantial morbidity in children worldwide. Case report: An eight-year-old boy was admitted to the pediatric clinic in Osijek for treatment of right- sided lobar pneumonia complicated by pleural effusion. He was initially treated in General County Hospital of Vinkovci (GCH Vinkovci). He was febrile, with poor general appearance and tachydyspnea. On the right lung was an extremely weakened breathing sound. He was treated with oxygen therapy, parenterally rehydrated with continuation of the previously started antimicrobial therapy with ceftriaxone. Vancomycin was introduced. After radiological examination, a thoracic drain was placed. The effusion was an exudate and microbiologically sterile, however Streptococcus pneumoniae, Streptococcus pyogenes and Respiratory syncytial virus were isolated in GCH Vinkovci. After the initial drainage of 500 millilitres of effusion, a partial decrease in inflammatory parameters was observed. A sparing thoracotomy with lung decortication was performed. In the further course, a gradual recovery follows, both clinically and laboratory, and with physical respiratory therapy there is a significant recovery of respiratory function. The child was in a clinically stable condition with meropenem and vancomycin in therapy and was transferred to the pulmonology department. There was a re-increase of inflammatory parameters with pancytopenia and fever going up to 40°C. Tazocin was introduced into therapy instead of meropenem. Two days later, the blood count recovers, and the inflammatory parameters decrease. One week after discharge, consolidation is no longer visible on ultrasound. Conclusion: This case report once again underlines the importance and urgency of treating pneumonia in children and the possibility of complications that can arise.

pediatrics, pleural effusion, pneumonia

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