Absentee pneumonia

It occurs most often in sepsis, mainly as a complication of staphylococcal pneumonia.

Staphylococcal pneumonia[edit | edit source]

Now rare, more common in infants than older children,
is serious for a progressive course with a tendency to complications - abscessy and pyopneumothorax,
Staphylococcus aureus, has various toxins and enzymes (hemolysin, leukocidin, staphylokinase, plasma coagulase),
routes of spread of infection are bronchogenic or hematogenous.

The foci of inflammation merge together, aureus multiplies rapidly, destroys the surroundings, causes the formation of small abscesses,
pyopneumothorax results from the rupture of abscesses located subpleurally,
partial obstruction of small bronchi can lead to the formation of pneumatoceles,
septic thrombi can form in the pulmonary veins.

Sudden high fever, shortness of breath,
can be simultaneously staphyloderma,
in infants, it occurs peracutely as a septicotoxic form,
physical finding: initially a finding typical of pneumonia, when empyema or pyopneumothorax then weakens breathing,
laboratory examination: marked leukocytosis, neutrophilia, left shift, anemia, high sedimentation and CRP, often a positive blood culture ,
'heart+lung x-ray: initially small bronchopneumonic foci, they quickly expand and gradually merge,
- formation of effusion,
- abscesses – they form cavities with a wide rim (they are filled with air after emptying the contents into the bronchus),
complications: only rare with targeted ATB therapy, in younger infants – staphylococcal pericarditis, meningitis, osteomyelitis, metastatic abscesses, sepsis.

In the initial stage, heavy,
in the anamnesis, information about the mother's history of staphyloderma or mastitis helps us,
further: clinical picture, x-ray S+P, culture,
differential diagnosis: pneumonia, which can be complicated by empyema (causing agents: streptococcus, klebsiella, hemophilus).

Antistaphylococcal ATB – oxacillin', vancomycin' (3-4 weeks),
i.v. helps to cope application of Ig or antistaphylococcal serum,
empyema – cavity drainage (max. 7 days),
prognosis – serious, high mortality – is influenced by the patient's premorbid condition and complications.