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Pneumatocele Treatment & Management

  • Author: Denise Serebrisky, MD; Chief Editor: Michael R Bye, MD  more...
 
Updated: Jan 31, 2016
 

Medical Care

Medical care for pneumatocele is treatment of the underlying condition. In most circumstances, this involves administration of broad-spectrum antibiotics to treat the pneumonia. Therapy should be directed against the most common bacterial organisms in children, including S aureus and S pneumoniae.

Positive pressure ventilation can result in a sudden increase in size and tension of a pneumatocele. Therefore, careful monitoring is essential in patients receiving positive pressure ventilation when pneumatoceles have been documented.

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Surgical Care

Pneumatoceles almost never require surgical resection. As mentioned above, percutaneous catheter drainage of a pneumatocele that involves more than 50% of hemithorax with severe atelectasis, tension pneumatocele, bronchopleural fistula, or an infected pneumatocele is rarely required. Recently, video-assisted thoracoscopy has been used successfully to treat enlarging multicystic pneumatoceles.[16]

Traumatic pneumatoceles commonly resolve with observation without additional therapy. Indications for surgical intervention with a traumatic pneumatocele are similar to those of a postinfectious pneumatocele (ie, development of tension pneumatoceles, a secondary infection of the pneumatocele, and cardiovascular compromise).

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Consultations

Consider consulting a surgeon in the presence of an infected pneumatocele or a tension pneumatocele and/or in the presence of a persistent bronchopleural fistula.

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Diet

No special dietary requirements are indicated.

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Activity

Caution patients with pneumatocele against skydiving or exposure to very high altitudes because of an increased risk of pneumothorax. Scuba diving must be avoided until the pneumatocele completely heals.

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Contributor Information and Disclosures
Author

Denise Serebrisky, MD Associate Professor, Department of Pediatrics, Albert Einstein College of Medicine; Director, Division of Pulmonary Medicine, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center/North Central Bronx Hospital; Director, Jacobi Asthma and Allergy Center for Children, Jacobi Medical Center

Denise Serebrisky, MD is a member of the following medical societies: American Thoracic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Arthur B Atlas, MD Assistant Clinical Professor, Department of Pediatrics, University of Medicine and Dentistry of New Jersey

Arthur B Atlas, MD is a member of the following medical societies: American Academy of Pediatrics, American Academy of Sleep Medicine, American College of Chest Physicians, American Lung Association, American Thoracic Society, Medical Society of New Jersey

Disclosure: Received grant/research funds from astra zeneca for none.

Debra Boyer, MD Fellow, Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital of Boston

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO Professor, Chief, Department of Pediatrics and Pediatric Pulmonology, Tripler Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Michael R Bye, MD Professor of Clinical Pediatrics, State University of New York at Buffalo School of Medicine; Attending Physician, Pediatric Pulmonary Division, Women's and Children's Hospital of Buffalo

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Girish D Sharma, MD, FCCP, FAAP Professor of Pediatrics, Rush Medical College; Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush Children's Hospital, Rush University Medical Center

Girish D Sharma, MD, FCCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

References
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Pneumonia with multiple pneumatoceles.
Pneumonia with pneumatocele (lateral).
Resolving pneumatocele.
Chest CT scan of pneumonia with pneumatocele.
 
 
 
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