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    "textoCompleto" => "<p class="elsevierStylePara">To the Editor&#44;</p><p class="elsevierStylePara">Lung abscess is uncommon in children with an estimated incidence of 0&#46;7 per 100&#44;000 admissions&#47;year&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a> Literature concerning this topic is scarce&#46;</p><p class="elsevierStylePara">The authors carried out a retrospective study of hospital admissions of children with lung abscess from January 1990 to December 2013&#46;</p><p class="elsevierStylePara">Twenty admissions occurred&#44; related to 18 children &#40;two had recurrent secondary lung abscesses with hyper IgE syndrome and congenital cyst adenomatoid malformation as underlying conditions&#41;&#46; Twelve admissions &#40;60&#37;&#41; were male children and ages ranged from 8 months to 12 years &#40;mean of 3 years&#41;&#46; Eleven cases &#40;55&#37;&#41; were primary lung abscesses&#46; Congenital cystic adenomatous malformation&#44; immunodeficiency and neurodevelopment abnormality were the underlying conditions related to the secondary lung abscesses&#46; The most common symptoms were fever &#40;100&#37;&#41;&#44; cough &#40;60&#37;&#41;&#44; chest&#47;abdominal pain &#40;45&#37;&#41; and dyspnea &#40;30&#37;&#41; with a mean duration of 13 days &#40;range 3&#8211;60&#41;&#46; The chest radiography was diagnostic in every case&#46; A chest computerized tomography &#40;CT&#41; scan was done in 65&#37; and diagnosed congenital cyst adenomatous malformations in two cases&#46; The right lung was involved in 64&#37;&#46; Microbiological studies were made in 70&#37; admissions &#40;12 blood cultures&#44; 8 pleural fluid cultures&#44; 2 bronchoalveolar lavage cultures&#44; 3 sputum cultures&#44; 1 abscess fluid culture&#41;&#46; Identification of an agent was possible in 21&#37; of these cases &#40;<span class="elsevierStyleItalic">Streptococcus pneumoniae</span> in two blood cultures and one bronchoalveolar lavage and <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> in one sputum culture&#41;&#46; The average hospital stay was 18 days &#40;range 5&#8211;39&#41;&#46; In all admissions&#44; combination IV antibiotics were administered&#44; with an average duration of 17 days&#46; Antibiotics included a third generation cephalosporin in 85&#37;&#44; an antistaphylococcal agent in 80&#37; and an antifungal agent in 10&#37; &#40;in one child&#44; the immunodeficiency diagnosis was made in follow-up and did not receive antifungal therapy for that reason&#41;&#46; Radiologically guided needle aspiration was performed in one secondary lung abscess that failed to respond to antibiotic treatment&#46;</p><p class="elsevierStylePara">There were complications in two cases &#40;one piopneumothorax and bronchopleural fistula&#59; one large pneumotocele&#41;&#46; There were no deaths directly related to lung abscess&#46;</p><p class="elsevierStylePara">Lung abscesses are uncommon in pediatric age&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a> There was a delay in diagnosis in our study that is common given the abscess insidious evolution&#46; The main diagnostic test was the chest radiography&#44;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> but chest CT was useful for identification of predisposing&#47;associated lung lesions and aspiration guidance&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a> The most frequent location was the right lung&#44; probably a result of the anatomic position of the right main bronchus&#46;<a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a> Microbiologic findings were scarce which could be explained by our minimally invasive approach&#46; <span class="elsevierStyleItalic">P&#46; aeruginosa</span> sputum culture had uncertain significance&#46; To clarify the microbiologic etiology of the lung abscess&#44; the ideal samples are the ones that result from percutaneous aspiration of the abscess or transtracheal aspirates&#46; The samples of the upper respiratory tract are of no value&#46;<a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> In addition to cultures&#44; rapid diagnostic tests&#44; such polymerase chain reaction techniques&#44; can also be helpful&#46;</p><p class="elsevierStylePara">The choice and length of the antibiotic regimen was usually recommended&#44; covering upper respiratory flora and also anaerobes in second lung abscess and fungal pathogens in immunocompromised children&#46;<a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a></p><p class="elsevierStylePara">In conclusion&#44; lung abscess has a low incidence in pediatric age and our series showed that a conservative approach still is an appropriate choice&#46;</p><a name="sec0005" class="elsevierStyleCrossRefs"></a><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p class="elsevierStylePara">The authors have no conflicts of interest to declare&#46;</p><p class="elsevierStylePara">Corresponding author&#46; alexandra&#46;raquel&#64;gmail&#46;com</p>"
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Lung abscesses in children – Twenty four years of experience
A.. Oliveiraa,
Corresponding author
alexandra.raquel@gmail.com

Corresponding author. alexandra.raquel@gmail.com
, L.. Martinsa, M.. Félixa
a Pediatric Medical Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Portugal
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    "textoCompleto" => "<p class="elsevierStylePara">To the Editor&#44;</p><p class="elsevierStylePara">Lung abscess is uncommon in children with an estimated incidence of 0&#46;7 per 100&#44;000 admissions&#47;year&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a> Literature concerning this topic is scarce&#46;</p><p class="elsevierStylePara">The authors carried out a retrospective study of hospital admissions of children with lung abscess from January 1990 to December 2013&#46;</p><p class="elsevierStylePara">Twenty admissions occurred&#44; related to 18 children &#40;two had recurrent secondary lung abscesses with hyper IgE syndrome and congenital cyst adenomatoid malformation as underlying conditions&#41;&#46; Twelve admissions &#40;60&#37;&#41; were male children and ages ranged from 8 months to 12 years &#40;mean of 3 years&#41;&#46; Eleven cases &#40;55&#37;&#41; were primary lung abscesses&#46; Congenital cystic adenomatous malformation&#44; immunodeficiency and neurodevelopment abnormality were the underlying conditions related to the secondary lung abscesses&#46; The most common symptoms were fever &#40;100&#37;&#41;&#44; cough &#40;60&#37;&#41;&#44; chest&#47;abdominal pain &#40;45&#37;&#41; and dyspnea &#40;30&#37;&#41; with a mean duration of 13 days &#40;range 3&#8211;60&#41;&#46; The chest radiography was diagnostic in every case&#46; A chest computerized tomography &#40;CT&#41; scan was done in 65&#37; and diagnosed congenital cyst adenomatous malformations in two cases&#46; The right lung was involved in 64&#37;&#46; Microbiological studies were made in 70&#37; admissions &#40;12 blood cultures&#44; 8 pleural fluid cultures&#44; 2 bronchoalveolar lavage cultures&#44; 3 sputum cultures&#44; 1 abscess fluid culture&#41;&#46; Identification of an agent was possible in 21&#37; of these cases &#40;<span class="elsevierStyleItalic">Streptococcus pneumoniae</span> in two blood cultures and one bronchoalveolar lavage and <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> in one sputum culture&#41;&#46; The average hospital stay was 18 days &#40;range 5&#8211;39&#41;&#46; In all admissions&#44; combination IV antibiotics were administered&#44; with an average duration of 17 days&#46; Antibiotics included a third generation cephalosporin in 85&#37;&#44; an antistaphylococcal agent in 80&#37; and an antifungal agent in 10&#37; &#40;in one child&#44; the immunodeficiency diagnosis was made in follow-up and did not receive antifungal therapy for that reason&#41;&#46; Radiologically guided needle aspiration was performed in one secondary lung abscess that failed to respond to antibiotic treatment&#46;</p><p class="elsevierStylePara">There were complications in two cases &#40;one piopneumothorax and bronchopleural fistula&#59; one large pneumotocele&#41;&#46; There were no deaths directly related to lung abscess&#46;</p><p class="elsevierStylePara">Lung abscesses are uncommon in pediatric age&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a> There was a delay in diagnosis in our study that is common given the abscess insidious evolution&#46; The main diagnostic test was the chest radiography&#44;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> but chest CT was useful for identification of predisposing&#47;associated lung lesions and aspiration guidance&#46;<a href="&#35;bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a> The most frequent location was the right lung&#44; probably a result of the anatomic position of the right main bronchus&#46;<a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a> Microbiologic findings were scarce which could be explained by our minimally invasive approach&#46; <span class="elsevierStyleItalic">P&#46; aeruginosa</span> sputum culture had uncertain significance&#46; To clarify the microbiologic etiology of the lung abscess&#44; the ideal samples are the ones that result from percutaneous aspiration of the abscess or transtracheal aspirates&#46; The samples of the upper respiratory tract are of no value&#46;<a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> In addition to cultures&#44; rapid diagnostic tests&#44; such polymerase chain reaction techniques&#44; can also be helpful&#46;</p><p class="elsevierStylePara">The choice and length of the antibiotic regimen was usually recommended&#44; covering upper respiratory flora and also anaerobes in second lung abscess and fungal pathogens in immunocompromised children&#46;<a href="&#35;bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44; </span><a href="&#35;bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a></p><p class="elsevierStylePara">In conclusion&#44; lung abscess has a low incidence in pediatric age and our series showed that a conservative approach still is an appropriate choice&#46;</p><a name="sec0005" class="elsevierStyleCrossRefs"></a><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p class="elsevierStylePara">The authors have no conflicts of interest to declare&#46;</p><p class="elsevierStylePara">Corresponding author&#46; alexandra&#46;raquel&#64;gmail&#46;com</p>"
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Article information
ISSN: 08732159
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2021 January 148 58 206
2020 December 139 42 181
2020 November 116 32 148
2020 October 103 24 127
2020 September 139 44 183
2020 August 157 71 228
2020 July 144 44 188
2020 June 111 30 141
2020 May 125 43 168
2020 April 140 33 173
2020 March 164 110 274
2020 February 145 47 192
2020 January 174 38 212
2019 December 146 37 183
2019 November 148 37 185
2019 October 145 47 192
2019 September 144 41 185
2019 August 181 35 216
2019 July 139 35 174
2019 June 142 18 160
2019 May 158 50 208
2019 April 131 43 174
2019 March 172 20 192
2019 February 115 18 133
2019 January 136 30 166
2018 December 54 17 71
2018 November 17 0 17
2018 October 40 10 50
2018 September 27 13 40
2018 August 55 42 97
2018 July 29 28 57
2018 June 40 13 53
2018 May 30 20 50
2018 April 50 19 69
2018 March 62 20 82
2018 February 11 4 15
2018 January 14 10 24
2017 December 20 21 41
2017 November 18 15 33
2017 October 20 16 36
2017 September 27 11 38
2017 August 22 18 40
2017 July 13 16 29
2017 June 17 16 33
2017 May 17 16 33
2017 April 12 4 16
2017 March 9 1 10
2017 February 5 5 10
2017 January 9 6 15
2016 December 8 8 16
2016 November 12 7 19
2016 October 4 0 4
2016 September 6 5 11
2016 August 9 11 20
2016 July 15 17 32
2016 June 3 0 3
2016 May 23 0 23
2016 April 10 10 20
2016 March 25 26 51
2016 February 27 20 47
2016 January 19 18 37
2015 December 59 42 101
2015 November 60 42 102
2015 October 92 68 160
2015 September 131 109 240
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