Hydropneumothorax in Patient with Community Acquired Pneumonia and Sepsis

IN A 1-MONTH-OLD CHILD : CASE REPORT

Nurul Hudayani, Idham Jaya Ganda, Siti Aizah Lawang
Department of Paediatric, Faculty of medicine, Hasanuddin University,
Dr.Wahidin Sudirohusodo general Hospital, Makassar, Indonesia

Abstract

Background. Hydropneumothorax is a condition where there is free air and fluid in the pleural
cavity which results in collapse of lung tissue. Hydropneumothorax is a disorder that is very rarely
found, through radiological examination characterized by the presence of free fluid and air in the
pleural cavity. The incidence and prevalence of hydropneumothorax are still very little reported.
The incidence and prevalence of pneumothorax ranged from 2.4 to 17.8 per 100,000 population
per year. Hydropneumothorax can occur due to complications of thoracenthesis, thoracic trauma,
esophagopleural fistula and bronchopleural fistula. Hydropneumothorax is very rare in the
population of children and most of them are complications of pneumonia with bronchopleural
fistulas. Pneumonia with complications of hydropneumothorax is very rare and only reported in
few cases. This condition is treated by installing water seal drainage (WSD) to drain fluid and air
from the pleural cavity.

Objective. To report a case of hydropneumothorax in patient with Community Acquired

Pneumonia and Sepsis in a a-one-month-and-fourteen-day-aged boy

Case. A-one-month-and-fourteen-day-aged boy was admitted with shortness of breathing since

2 days before admission. He has no history of blue-colored skin. There was history of coughing
with no sputum since 3 days before admission. There was no history of fever and seizure. He was
admitted in Catherine Booth Hospital for 3 weeks with abscess on face and it was drained.
Physical examination revealed as follows: respiratory rate was 68/minutes, SpO2 was 97%(with
no rebreathing mask); heart rate was 162/minutes, temperature was 37oC. From thoracal
examination, it was found subcostal, intercostal, and suprasternal retraction. His breathing sound
was bronchovesicular. There was decreased of breathing sound in left hemithorax. We also found
ronchi in right hemithorax. Laboratory findings revealed as follows: hemoglobin was 11.8 gr / dl;
leukocyte was 34,860 / mm3, platelet was 275,000 / mm3, 92% of granulocytes, 5.8% of
lymphocytes. Culture (Rs. Catherina booth) showed: Serratia plymuthica, blood culture result:
Staphylococcus aureus. Chest radiograph: bilateral pneumonia, left pleural effusion. CT scan of
thorax revealed left hydropneumthorax, right pneumonia, and bilateral atelectasis. He was treated
with WSD and antibiotics.

Conclusion. A case of hydropneumothorax, CAP, and sepsis in a-one-month-and-fourteen-day-

aged boy was reported. The diagnosis was based on history taking, physical examination,
laboratory and radiologic examination findings. The prognosis was dubia

Keywords : Hidropbeumothorax, Sepsis, Pneumonia