A 1.5 year-old girl is admitted to Pediatric ward with cough, fever, and mild hypoxia. At the time of her admission, on CXR left upper lobe consolidation is seen. Staphylococcus aureus is seen on blood culture within 24 hours. Suddenly the child’s condition acutely worsened over the past few minutes, with markedly increased work of breathing, increasing oxygen requirement, and hypotension. On examination there was decreased air entry in left hemithorax and hea sounds were more audible on the right side of chest as compared to left. What could be the possible reason?
Correct Answer: Tension pneumothorax
Description: Above clinical scenario suggestive of the diagnosis of Tension Pneumothorax In Tension pneumothorax, continuing leak causes increasing positive pressure in the pleural space, leading to compression of the lung, shift of mediastinal structures toward the contralateral side like kinking of Superior vena cava which cause decreases in venous return and cardiac output leading to hemodynamic instability like Hypotension. Staph is responsible for causing pneumatocele; so rupture ;ends to pneumothorax Treatment:- Immediate decompression + wide bore needle into 5th ICS - mid axillary line
Category:
Pediatrics
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