LUNG BULLAE DUE TO SEPTIC PULMONARY EMBOLISM IN A 4-YEAR-OLD CHILD: A CASE REPORT
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Erina Febriani Widiastari*
Wirya Ayu Graha
Marolop Pardede
Bullous lung disease in pediatric patients is a rare case. The etiology of lung bullae is cigarette smoking history, pulmonary sarcoidosis, alpha 1-antitrypsin deficiency and many more. One of the treatments for lung bulla is surgical approach. We present a case of 4-year-old girl with lung bulla due to septic pulmonary embolism. Primarily the patient was admitted with a decrease in consciousness, fever, cough and dyspnea. A CT scan revealed bilateral bullae, multiple nodules in various size, mostly with internal cavities and feeding vessel sign suggestive of a septic pulmonary embolism accompanied by a pneumothorax. We did thoracotomy, wedge resection and pleurodesis, the outcome was clinical improvement and no postoperative complication occurred. Thoracotomy, wedge resection and pleurodesis can be considered as a treatment for lung bulla in pediatric population, so this case report may provide guidance on management of these cases for clinicians.
Chou, D.-W., Wu, S.-L., Chung, K.-M., Han, S.-C., & Cheung, B. M.-H. (2016). Septic pulmonary embolism requiring critical care: clinicoradiological spectrum, causative pathogens and outcomes. Clinics, 71, 562–569.
Devu, B. K., & Joseph, J. K. (2019). A case of Bullous lung disease. Indian Journal of Public Health, 10(12), 867.
Goldberg, C., & Carey, K. E. (2013). Bullous lung disease. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 14(5).
Grippi, M. A., Elias, J. A., Fishman, J. A., Pack, A. I., Senior, R. M., & Kotloff, R. (2015). Fishman’s Pulmonary Diseases and Disorders, 2-Volume Set. McGraw Hill Professional.
Joshi, V., Kirmani, B., & Zacharias, J. (2013). Thoracotomy versus VATS: is there an optimal approach to treating pneumothorax? The Annals of The Royal College of Surgeons of England, 95(1), 61–64.
Kano, Z., Onoyama, S., Tsuji, M., Tezuka, J., & Furuno, K. (2018). Klebsiella pneumoniae‐associated septic pulmonary emboli in a healthy child. Pediatrics International, 60(7), 663–665.
Kapoor, S., Thakkar, J., & Siddique, M. A. (2018). Septic pulmonary emboli causing recurrent bilateral pneumothoraces in a patient with right sided endocarditis: a case report and review of literature. SAGE Open Medical Case Reports, 6, 2050313X18784823.
Lee, S., Kim, H. R., Cho, S., Huh, D. M., Lee, E. B., Ryu, K. M., Cho, D. G., Paik, H. C., Kim, D. K., & Lee, S.-H. (2014). Staple line coverage after bullectomy for primary spontaneous pneumothorax: a randomized trial. The Annals of thoracic surgery, 98(6), 2005–2011.
Negussie, T., Haile, L., GebreSelassie, H. A., Temesgen, F., & Tizazu, A. (2020). Giant pulmonary bullae in children. Journal of Pediatric Surgery Case Reports, 60, 101569.
