Pneumatocele Treatment & Management

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

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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