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Antibiotics are ineffective, and the 7-year-old boy's right lung has become "honeycomb coal"! Many people have been diagnosed recently, and Qingdao doctors have reminded →
Beijing Youth Daily2025-02-20 09:50
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7-year-old boy Xiaoyu (pseudonym) half a month ago
Sudden high fever and cough
His parents took him to a local clinic.
Diagnosed as "respiratory tract infection"
The anxious parents brought Xiaoyu to
Peking University People's Hospital Qingdao Branch
The child was immediately admitted to the pediatric respiratory ward
After bronchoscopy
Xiaoyu's temperature returned to normal
Coughing is significantly relieved
Continuous intravenous infusion of antibiotics did not improve
Came to Qingdao for inspection and found
The right lung has progressed to "necrotizing pneumonia"
It is understood that Xiaoyu, the parent, underwent a chest CT scan at a local hospital and was found to have "large-area inflammation of the right lung with atelectasis". He was immediately hospitalized for treatment and received continuous intravenous infusion of "azithromycin + cephalosporin" antibiotics for 7 days, but there was still no improvement.
At this time, Xiaoyu was already very weak and listless. Seeing that conventional anti-infection treatment was ineffective, the local hospital recommended transfer to another hospital for treatment. The anxious parents took Xiaoyu to the Qingdao Hospital of Peking University People's Hospital for treatment, and the child was immediately admitted to the pediatric respiratory department.
When the child was hospitalized, he had already developed chest pain, shortness of breath, and coughing up bloody sputum. After further examination, the right lung had progressed to "necrotizing pneumonia". Enhanced CT images showed multiple honeycomb-like cavities in the right lung, and his condition was critical.
According to reports, necrotizing pneumonia is a rare but serious complication of pneumonia, characterized by ischemia, necrosis, and liquefaction of lung tissue due to pathogen infection and excessive immune response, forming lesions similar to "honeycomb coal" or "cavity".
The disease can occur in people of all ages, and the incidence among children has gradually increased in recent years.
Necrotic pneumonia is a serious condition. In the acute phase, complications such as parapneumonic pleural effusion, pneumothorax, and bronchopleural fistula may occur. The course of the disease is long, and the absorption time of lung lesions varies from months to years. Some patients with poor prognosis may have sequelae such as atelectasis or cystic changes in the lung lobes, and obliterative bronchitis.
Bronchoscope for precise debridement
Reversing the disease
Faced with Xiaoyu's critical situation of extensive necrosis in the right lung, the pediatric respiratory medicine team immediately applied to the medical department, organized a multidisciplinary consultation, and developed a treatment plan:
Emergency bronchoscopic intervention to remove necrotic tissue: Under the microscope, it can be seen that the lesions are filled with yellow-brown pus plugs and necrotic materials, and some bronchi have been blocked. The airways are completely cleared by clamping the necrotic tissue, lavage and suction.
After atelectasis was relieved and the mucus plug was sucked out, the collapsed lung tissue gradually expanded and Xiaoyu's shortness of breath gradually eased.
Local drug infusion, microscopic spraying of expectorants and drugs that promote lung tissue repair can prevent sputum plugs from blocking the trachea again and promote lung tissue repair.
Experts subsequently adjusted the systemic treatment plan, adjusted the medication based on pathogen testing (pathogen targeted sequencing indicated drug-resistant mycoplasma infection), and used glucocorticoids in the short term to control excessive inflammatory response.
After two bronchoscopic treatments, Xiaoyu's temperature returned to normal, his cough was significantly relieved, and he no longer had chest pain or coughing up bloody sputum. He was discharged from the hospital after 10 days of hospitalization.
A recent CT scan showed that the necrotic cavity in the right lung was basically absorbed, the atelectasis was completely resolved, and there were no sequelae such as obliterative bronchitis.
It is reported that bronchoscopy technology, a "weapon" for treating severe pneumonia in children, has developed from a traditional diagnostic tool into an important treatment for respiratory diseases. It is especially suitable for: severe pneumonia with mucus plugs or necrotic obstructions; refractory mycoplasma pneumonia, adenovirus pneumonia; congenital airway malformations, bronchial foreign bodies, etc.
In recent times, the pediatric respiratory medicine team has successfully treated several critically ill children with necrotizing pneumonia caused by mycoplasma infection through bronchoscopic intervention technology.
Bronchoscopy technology has significant advantages in the treatment of critical respiratory diseases in children and provides strong protection for children's respiratory health.
Pediatric respiratory physicians remind:
Early identification is key
The early symptoms of necrotizing pneumonia may be similar to those of ordinary pneumonia, but the disease progresses faster and is accompanied by the following "danger signals": persistent high fever, body temperature ≥39°C, poor response to conventional anti-infection treatment, and fever that has not been relieved for more than 5 days;
The cough continues to worsen, and the dry cough turns into yellow purulent sputum, and even blood in the sputum, chest pain and other symptoms; difficulty breathing, shortness of breath, flaring of the nose, and cyanosis of the lips;
Systemic exhaustion, mental depression, refusal to eat, cold limbs, and in severe cases, confusion or shock; worsening of infection, pneumonia manifested by lobar consolidation shows abnormally elevated infection indicators, and repeat CT scans show the presence of single or multiple thin-walled cavities or low-density areas.
How can parents protect their children's lung health? Vaccinations with pneumococcal vaccine and influenza vaccine can significantly reduce the risk of severe pneumonia.
Identify early symptoms. If you have a fever for more than 3 days, a rapid breathing rate, or mental depression, you need to see a doctor immediately. Standardize treatment, strictly follow the doctor's instructions, take enough medicine for a full course of treatment, and do not stop taking medicine at will. Enhance immunity, balance nutrition, exercise moderately, and ensure sleep.
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