Medical Care
Medical care for pneumatocele is treatment of the underlying condition. In most circumstances, this involves administration of broad-spectrum antibiotics to treat the pneumonia. Therapy should be directed against the most common bacterial organisms in children, including S aureus and S pneumoniae.
Positive pressure ventilation can result in a sudden increase in size and tension of a pneumatocele. Therefore, careful monitoring is essential in patients receiving positive pressure ventilation when pneumatoceles have been documented.
Surgical Care
Pneumatoceles almost never require surgical resection. As mentioned above, percutaneous catheter drainage of a pneumatocele that involves more than 50% of hemithorax with severe atelectasis, tension pneumatocele, bronchopleural fistula, or an infected pneumatocele is rarely required. Video-assisted thoracoscopy has been used successfully to treat enlarging multicystic pneumatoceles. [16] Muniraman et al reported that bedside ultrasound-guided chest tube drainage was used to decompress a large pneumatocele in an unstable preterm infant. [17]
Traumatic pneumatoceles commonly resolve with observation without additional therapy. Indications for surgical intervention with a traumatic pneumatocele are similar to those of a postinfectious pneumatocele (ie, development of tension pneumatoceles, a secondary infection of the pneumatocele, and cardiovascular compromise).
Consider consulting a surgeon in the presence of an infected pneumatocele or a tension pneumatocele and/or in the presence of a persistent bronchopleural fistula.
Diet and Activity
Diet
No special dietary requirements are indicated.
Activity
Caution patients with pneumatocele against skydiving or exposure to very high altitudes because of an increased risk of pneumothorax. Scuba diving must be avoided until the pneumatocele completely heals.
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Pneumonia with multiple pneumatoceles.
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Pneumonia with pneumatocele (lateral).
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Resolving pneumatocele.
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Chest CT scan of pneumonia with pneumatocele.
