Abstract
Introduction. Empyema thoracis, defined as the accumulation of pus in the
pleural space, is rare in neonatal population. There are limited data
reported in the medical literature and there are still no treatment
guidelines available for this age. Case report. We present a healthy term
12-day-old neonate with sepsis caused by methicillin-resistant
Staphylococcus aureus (MRSA) and pneumonia associated with advanced stage
empyema. The child was admitted to our hospital with a few-hours history of
difficulty breathing and lethargy. At the admission, the child was cyanotic
with desaturation, in severe respiratory distress, so it was intubated and
started mechanical ventilation. Imaging tests were performed in emergency,
therefore chest computed tomography (CT) scan was done without contrast.
Suspected congenital pulmonary airway malformation (CPAM) with trapped air
collections, significant mediastinal shift on CT scan and deterioration of
the patient?s condition indicated urgent surgery. Intraoperatively, the
diagnosis of stage 2 empyema was established, and decortication of thickened
parietal and visceral pleura was performed. Afterwards the baby showed quick
and progressive clinical improvement. Conclusion. The diagnosis and
management of empyema in neonates may be a challenging one, especially in
the case of unremarkably history, fulminant and rapid progression of the
disease and incomplete imaging tests.
Publisher
National Library of Serbia