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ARTICLE |

Diagnostic Significance of Pneumatocele of the Lung FREE

David E. Dines, MD
[+] Author Affiliations

Reprint requests to Mayo Clinic, Rochester, Minn 55901.


JAMA. 1968;204(13):1169-1172. doi:10.1001/jama.1968.03140260009003
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Staphylococcal pneumonia is frequently complicated by development of pneumatoceles. Pulmonary change with development of the pneumatocele, as seen roentgenographically, is more common in infants and children but can occur in young adults. Our four cases demonstrate the significance of pneumatoceles in the course of acute suppurative pneumonia. Pneumatoceles have been known to occur in 61% of cases of staphylococcal pneumonia. The pneumatocele develops from perforation of an abscess into a bronchial wall, thus permitting air to enter the abscess cavity. A check-valve mechanism due to obstruction by inflammation and edema creates tension produced by the air trapping. Pneumatoceles usually appear within the first week of pneumonia and disappear in an average of six weeks. Surgical intervention is necessary only when pneumatoceles grow large enough to cause cardiorespiratory embarrassment by compression or by rupture into the pleural space.

REFERENCES

Brünner, S.; Baekgaard, J.V.; and Halberg, P.:  Radiographic Manifestations of Staphylococcal Pneumonia in Infants and Children , Danish Med Bull 10:42-45 ( (April) ) 1963;.
Ch'Eng-Pin, H.; Yun-Ju, C.; and K'uei-Chin, M.:  Staphylococcal Pneumonia in Adults , Chin Med J 84:666-671 ( (Oct) ) 1965;.
Yesner, R.; Bernstein, S.; and D'Esopo, N.D.:  The Evolution of Bullous Cavities in Adequately Treated Experimental Pulmonary Tuberculosis , Amer Rev Resp Dis 82:810-823 ( (Dec) ) 1960;.
Steenken, W., Jr., and Wolinsky, E.:  Formation of Bullae or Cystlike Cavities During Chemotherapy in Rabbits With Pulmonary Tuberculosis , Amer Rev Tuberc 75:965-974 ( (June) ) 1957;.
Bell, J.W.:  Experimental Pulmonary Emphysema: Production of Emphysematous Bullae in the Rabbit by Injection With Tuberculosis , Amer Rev Tuberc 78:848-861 ( (Dec) ) 1958;.
Caffey, J.:  Regional Obstructive Pulmonary Emphysema in Infants and in Children: Emphysematous Cavities and Their Similarity to Necrotic Cavities, Congenital Pulmonary Cysts and Loculated Pneumothorax , Amer J Dis Child 60:586-605 ( (Sept) ) 1940;.
Pont, M.E., and Rountree, W.C.:  The Medical and Surgical Treatment of Staphylococcal Pneumonia , Dis Chest 43:176-185 ( (Feb) ) 1963;.
Slim, M.S.; Firzli, S.S.; and Melhem, R.E.:  Staphylococcic Pneumonia in Infants Under the Age of Six Months , Dis Chest 48:6-13 ( (July) ) 1965;.
Smith, M.H.D.: " Bacterial Pneumonias ," in Kendig, E.L., Jr.: Disorders of the Respiratory Tract in Children , Philadelphia: W.B. Saunders Co., 1967;, pp 292-296.
Schultze, G.:  Unusual Roentgen Manifestations of Primary Staphylococcal Pneumonia in Infants and Young Children , Amer J Roentgen 81:290-295 ( (Feb) ) 1959;.
Oliver, T.K., Jr.; Smith, B.; and Clatworthy, H.W., Jr.:  Staphylococcal Pneumonia: Pleural and Pulmonary Complications , Pediat Clin N Amer 6:1043-1054 ( (Nov) ) 1959;.
Pryles, C.V.:  Staphylococcal Pneumonia in Infancy and Childhood: An Analysis of 24 Cases , Pediatrics 21:609-623 ( (April) ) 1958;.
Potts, W.J., and Riker, W.L.:  Differentiation of Congenital Cysts of the Lung and Those Following Staphylococcic Pneumonia , Arch Surg 61:684-695 ( (Oct) ) 1950;.
Wallman, I.S.; Godfrey, R.C.; and Watson, J.R.H.:  Staphylococcal Pneumonia in Infancy , Brit Med J 2:1423-1427 ( (Dec 10) ) 1955;.
Liddle, H.V.:  Chronic Post-staphylococcic Pneumatocele: Report of a Case , Dis Chest 45:103-106 ( (Jan) 1964;.
Watkins, E., Jr., and Hering, A.C.:  The Management of Staphylococcal Tension Pneumatoceles by Intracavitary Suction Tube Drainage , J Thorac Cardiov Surg 36:642-653 ( (Nov) ) 1958;.
Rebhan, A.W., and Edwards, H.E.:  Staphylococcal Pneumonia: A Review of 329 Cases , Canad Med Assoc J 82:513-517 ( (March 5) ) 1960;.

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Brünner, S.; Baekgaard, J.V.; and Halberg, P.:  Radiographic Manifestations of Staphylococcal Pneumonia in Infants and Children , Danish Med Bull 10:42-45 ( (April) ) 1963;.
Ch'Eng-Pin, H.; Yun-Ju, C.; and K'uei-Chin, M.:  Staphylococcal Pneumonia in Adults , Chin Med J 84:666-671 ( (Oct) ) 1965;.
Yesner, R.; Bernstein, S.; and D'Esopo, N.D.:  The Evolution of Bullous Cavities in Adequately Treated Experimental Pulmonary Tuberculosis , Amer Rev Resp Dis 82:810-823 ( (Dec) ) 1960;.
Steenken, W., Jr., and Wolinsky, E.:  Formation of Bullae or Cystlike Cavities During Chemotherapy in Rabbits With Pulmonary Tuberculosis , Amer Rev Tuberc 75:965-974 ( (June) ) 1957;.
Bell, J.W.:  Experimental Pulmonary Emphysema: Production of Emphysematous Bullae in the Rabbit by Injection With Tuberculosis , Amer Rev Tuberc 78:848-861 ( (Dec) ) 1958;.
Caffey, J.:  Regional Obstructive Pulmonary Emphysema in Infants and in Children: Emphysematous Cavities and Their Similarity to Necrotic Cavities, Congenital Pulmonary Cysts and Loculated Pneumothorax , Amer J Dis Child 60:586-605 ( (Sept) ) 1940;.
Pont, M.E., and Rountree, W.C.:  The Medical and Surgical Treatment of Staphylococcal Pneumonia , Dis Chest 43:176-185 ( (Feb) ) 1963;.
Slim, M.S.; Firzli, S.S.; and Melhem, R.E.:  Staphylococcic Pneumonia in Infants Under the Age of Six Months , Dis Chest 48:6-13 ( (July) ) 1965;.
Smith, M.H.D.: " Bacterial Pneumonias ," in Kendig, E.L., Jr.: Disorders of the Respiratory Tract in Children , Philadelphia: W.B. Saunders Co., 1967;, pp 292-296.
Schultze, G.:  Unusual Roentgen Manifestations of Primary Staphylococcal Pneumonia in Infants and Young Children , Amer J Roentgen 81:290-295 ( (Feb) ) 1959;.
Oliver, T.K., Jr.; Smith, B.; and Clatworthy, H.W., Jr.:  Staphylococcal Pneumonia: Pleural and Pulmonary Complications , Pediat Clin N Amer 6:1043-1054 ( (Nov) ) 1959;.
Pryles, C.V.:  Staphylococcal Pneumonia in Infancy and Childhood: An Analysis of 24 Cases , Pediatrics 21:609-623 ( (April) ) 1958;.
Potts, W.J., and Riker, W.L.:  Differentiation of Congenital Cysts of the Lung and Those Following Staphylococcic Pneumonia , Arch Surg 61:684-695 ( (Oct) ) 1950;.
Wallman, I.S.; Godfrey, R.C.; and Watson, J.R.H.:  Staphylococcal Pneumonia in Infancy , Brit Med J 2:1423-1427 ( (Dec 10) ) 1955;.
Liddle, H.V.:  Chronic Post-staphylococcic Pneumatocele: Report of a Case , Dis Chest 45:103-106 ( (Jan) 1964;.
Watkins, E., Jr., and Hering, A.C.:  The Management of Staphylococcal Tension Pneumatoceles by Intracavitary Suction Tube Drainage , J Thorac Cardiov Surg 36:642-653 ( (Nov) ) 1958;.
Rebhan, A.W., and Edwards, H.E.:  Staphylococcal Pneumonia: A Review of 329 Cases , Canad Med Assoc J 82:513-517 ( (March 5) ) 1960;.
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