D9_320 - QA Al Salmi

PEDIATRIC LUNG ABSCESS: A RETROSPECTIVE REVIEW OF 11 CASES IN OMAN Q A Al Salmi, S Al Ismaili Royal Hospital Child Health - Central Post Office (Oman) Introduction Pediatric lung abscess is a rare but serious infectious condition in children. Objective To describe the clinical manifestations, bacteriology, clinical management and outcome of childhood lung abscess in Oman. Methods We did a retrospective review of 11 patients with documented lung abscess who have been treated at the Royal Hospital, Oman, over a 7 years period from January 2000 to August 20006. Results Among the 11 patients (7 males, 4 females), 64% (7/11) were primary lung abscess, and 36% (4/11) had underlying medical conditions (secondary lung abscess). The underlying diseases in the secondary group included 1 patient with chronic granulomatous disease, 1 with insulin dependent diabetes mellitus, 1 with Ataxia-Telengectasia, 1 with chronic renal failure. All patients had fever on presentation. The other most common presenting symptoms were cough and breathlessness. 55% (6/11) had the abscess in the left lower lobe, 36% (4/11) in right lower lobe and 9% (1/11) in right middle lobe. Five patients (45%) had associated empyema. Bacteria were isolated from 2 patients. One with secondary lung abscess (CRF) grew Pseudomonas aeroginosa in blood, abscess aspirate and sputum culture. Another patient with primary abscess had Staphylococcus epidermidis in abscess aspirate. All patients were managed with broad spectrum antibiotics. Surgical interventions were performed in 4 patients. Follow up was available for 10 patients. Eight patients (73%) had complete resolution of the abscess. Two patients had residual cystic lung cavity causing recurrent infections; one has undergone abscess resection. There was no death in this series. Conclusion Thirty six percent of lung abscess in this series occurred in children with underlying medical conditions. Treatment is with appropriate antibiotics. Surgical intervention may be required when medical treatment fails. Prognosis is good in patients with primary lung abscess and depends on the underlying medical condition in secondary lung abscess.