PNEUMONIA, STILL A CHALLENGE FOR THE PEDIATRICIAN – CASE REPORT

Abstract

Pneumonia represents an inflammation of the pulmonary parenchyma that despite the multiple antibiotic classes available and despite the medical progresses, still leads to an increased mortality rate, especially in children. Deltfia acidovorans and Stenotrophomonas maltophilia are Gram-negative bacilli that can lead to respiratory infections. We present the case of a 2 years and 3-month old male patient, admitted in our clinic for the following reasons: productive cough, fever and loss of appetite. Based on the clinical exam, laboratory and paraclinical investigations, we established the diagnosis of right pneumonia associated with pleural effusion and we administered wide spectrum antibiotics. Nevertheless, the evolution was unfavorable, needing pleurotomy and drainage. From the pleural fluid, there were isolated two strains of bacteria, Delftia acidovorans and Stenotrophomonas maltophilia. We adjusted the antibiotic regimen according to antibiogram, with afterwards slowly favorable evolution. The particularity of the case consists in diagnosing a pneumonia with pleural effusion in a 2 years and 3-month-old child, without risk factors, who needed pleurotomy with thoracic drainage, in whom the pleural fluid revealed 2 germs usually encountered in immunocompromised individuals, with favorable evolution after the initiation of antibiotics regimen according to the antibiogram.

Keywords

• pneumonia
• child
• pleural effusion
• delftia acidovorans
• stenotrophomonas maltofilia