Staphylococcus epidermidis Necrotizing Pneumonia and Pneumatocele in a Term Infant

Coagulase negative staphylococcus necrotizing pneumonia
Vol. 4 No. 1 : 2009 (61-63)

Johan AJ Johan AJ
Cheah FC Cheah FC

Abstract
Staphylococcus epidermidisis emerging as an increasingly important pathogen in the immunocompromised host. We report here a case ofS. epidermidis necrotizing pneumonia complicated by pneumatoceles in a term male infant who had earlier undergone surgical repair of tracheo-esophageal fistula. He was treated with intravenous teicoplanin and gentamicin for four weeks followed by two weeks of erythromycin. No percutaneous aspiration or pleural drainage was required. He had complete clinical and radiologic recovery when seen at follow-up six months later. Aggressive antimicrobial therapy for this condition without surgical drainage resulted in complete resolution and avoided complications such as pneumothorax and bronchopleural fistula.
Keywords : coagulase negative staphylococcus, necrotizing pneumonia, pneumato-cele, Staphylococcus epidermidis, term infant,
Abstrak
Staphylococcus epidermidisadalah satu daripada patogen yang semakin penting da­lam hos yang terimunokompromi. Kami melaporkan di sini suatu kes pneumonia berne­krosis akibat S. epidermidis yang dikomplikasi dengan pneumatosel pada seo­rang bayi lelaki yang dilahir cukup bulan. Beliau menghidapi penyakit fistula trakeo-esofa­gus yang perlu dibedah sebelum kejadian ini. Rawatan dengan antibiotik “tei­coplanin” dan “gentamicin” diberikan selama empat minggu diikuti dengan “erythromy­cin” untuk dua minggu. Bayi tersebut tidak perlu menjalani aspirasi perkutaneus atau­pun penyaliran pleura dan ianya pulih sepenuhnya dari segi klinikal dan gambaran ra­diologi apabila ditemu enam bulan kemudiannya semasa lawatan tindaksusulan. Ra­watan dengan ubatan antimikrobial yang agresif mampu menjana pemulihan sepe­nuhnya tanpa mengakibatkan kerumitan dengan komplikasi seperti pneumotoraks dan fistula bron­kopleura.
Kata Kunci : bayi cukup bulan, pneumato-sil, pneumonia bernekrosis, stafilokokus tanpa enzim koagulasi, Staphylococcus epidermidis,

Correspondance Address
Professor Dr. Cheah Fook Choe, Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur. Tel: 603-9145 5391. Fax: 603-9173 7827. Email: cheahfc@ppukm.ukm.my