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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.


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).



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.



No special dietary requirements are indicated.



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.

Contributor Information and Disclosures

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.


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.

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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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