May 1986

Escherichia coli Empyema in the Newborn

Author Affiliations

Department of Pediatrics Louisiana State University Medical Center PO Box 33932 Shreveport, LA 71130

Am J Dis Child. 1986;140(5):408. doi:10.1001/archpedi.1986.02140190018005

Sir.—Spontaneous pyopneumothorax was reported in only six patients from 1946 to 1958; only two survived, with the mortality attributed to late recognition of this complication of pneumonia.1

Patient Report.—This 3,347-g male infant was born following a normal term pregnancy to a mother (gravida 2) with a healthy living child. Meconium-stained fluid was identified at delivery. Apgar scores were 7 and 9 at one and five minutes, respectively. The infant was intubated and Chest roentgenogram showing right-sided tension pneumothorax and fine perihilar infiltrates in patient at 6 hours of age. suctioned until tracheal fluid was clear. Respiratory distress was noted when he was 4 hours old. A chest roentgenogram revealed a right-sided tension pneumothorax (Figure). Acidosis and hypoxia responded to chest tube placement. Copious purulent fluid, with gram-negative bacilli, was obtained. Ampicillin sodium (200 mg/kg/day), gentamicin sulfate (5 mg/kg/day), and nafcillin sodium (100 mg/kg/day) were given. Continuous 15–cm

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