[Treatment of staphylococcal pneumonia in children]

Semisynthetic antibiotics combined with heparin and proteolysis inhibitors were used for the complex treatment of 110 children with staphylococcal destruction of lungs. Eleven children died. No heparin and inhibitors of proteolytic enzymes were used in the treatment of 158 children. Of this group 25 children died.

[Secondary abscessing pneumonia in children]

Among 370 patients with staphylococcic abscessing pneumonia in 55 secondary pulmonary involvement (14.8%) was noted. Acute hematogenic osteomyelitis was the most frequent cause of sepsis. The treatment of patients with secondary staphylociccic abscessing pneumonia is described. The mortality was 40 per cent.

Persistent pneumatoceles associated with systemic leukocyte abnormalities

Three patients with leucocyte related immune deficiency developed pneumatoceles during acute bacterial pneumonia. A fourth patient with chronic granulomatous disease of childhood developed persistent lung cysts following pulmonary abscesses. The pneumatoceles persisted without significant change for one year to five years. In 25 immunologically normal patients, pneumatoceles that were associated with acute bacterial pneumonia resolved in 3 weeks to 11 months. Perhaps alterations in leukocytic function and in local inflammatory response result in fibrotic cellular reaction and sequestration of parenchymal air collections, precluding their resorption.

[Methods for expanding the collapse lung in complicated abscessing pneumonia in children]

A comparative estimation of different methods of expanding the collapsed lung for staphylococcic pneumonia in children enabled the author to speak in favour of lung inflation by using an artificial occlusion of the bronchus with a peripheral fistula. This technic seems to be advantageous since a one-moment inclusion of the lung in the process of ventilation is found to contribute to prompt reduction oxygen deficiency of the organism, liquidation of the residual cavity and hemodynamic disturbances, and intoxication. The recovery of children is note din shorter terms. The time of patient's stay at the hospital is also shortened.

[Experience with treating complicated forms of abscessing pneumonia in children]

Under observation were 157 patients with different forms of abscessing pneumonias. Pleural complicaitons were noted in 113 patients (about 60%). The complex treatment was employed in all patients (intensive antibacterial therapy, immunotherapy, bacteriophage, administration of protein preparations, vitamin-therapy, fresh blood transfusion, artery system and by means of percutaneous catheterization of th subclavian vein. The results of the treatment are described.

Severe measles-associated pneumonia treated with assisted ventilation

Measles-associated pneumonia, which was severe enough to require mechanical ventilation, caused a mortality of 64%. The main indications for special respiratory care were severe infection and hypoxaemia. Complications of the disease occurred in 78% of the patients. The commonest were anaemia, enteritis and cardiac failure, and they contributed to the grave prognosis. Viral pneumonia was present in most of the patients who died; superinfection was rare. The characteristics of measles virus was present in 30% and of adenovirus in no less that 40%.

Pneumonia and pleural effusion. Association with influenza A virus and Staphylococcus aureus

An 8-month-old infant with severe pneumonia and massive pleural effusions was found to have concurrent infections due to Staphylococcus aureus and influenza A virus. This was proved by the isolation of both agents from the pleural fluid. We believe this is the first case of isolation of an influenza virus from pleural effusions.

[Surgical treatment of lung abscesses in children]

The authors report their clinical observations of 44 patients, aged from 2 months to 14 years, with acute pulmonary abscesses. As evidenced by the authors a roentgenological examination in dynamics is of great value in establishing the diagnosis of pulmonary abscess, since it makes possible to follow the destruction of lung tissues and the formation of cavities. For treatment of lung abscesses different methods were employed: toilet bronchoscopy with antibiotics perfusion, puncture and drainage of the abscess, in case of pulmonary hemorrhage a resection of the lung portion involved, the complex conservative therapy.

Fatal case of influenza pneumonia with suprainfection by multiple bacteria and Herpes simplex virus

A case of influenza pneumonia is described in which death occurred from persistence of the influenza infection and suprainfection with two bacteria, Staphylococcus aureus and Escherichia coli, and another virus, Herpes simplex. Of additional interest were the observations that this overwhelming illness developed in a previously healthy person, that typical influenza virus particles were present in antemortem lung tissue, and that the patient died despite 6 days of extracorporeal membrane oxygenation and corticosteroids.

[A case of fungiform mycosis with lesions of the internal organs]

A case of fungiform mycosis with involvement of the liver, kidneys, and the skin in a female patient aged 56 is described. Duration of the illness--2 months. Lesions of the skin localized on the face and upper extremities. The anamnesis revealed chronic bronchitis and bronchial asthma of a 15-year duration. The corticosteroid therapy resulted in destruction of tumour-like nodes on the skin, but the patient died because of a concomitant bilateral fibrous-purulent pneumonia. The diagnosis was established on clinical data (on bioptic specimens of the skin) and corroborated by sectional material.

Generalized seborrhoeic dermatitis. Clinical and therapeutic data of 25 patients

Twenty-five infants with generalized seborrhoeic dermatitis have been studied with reference to the provision of optimum treatment. Leucocyte counts and chest x-ray examination are recommended in every case. Irrespective of clinical findings, antibiotics should be given to patients with overt bacterial infection and those with leucocytosis, shift to the left, and toxic granulation. One group of infants was treated with vitamin B complex plus biotin given slowly intravenously over 24 hours; a second group was given only biotin intravenously over 2-3 hours; and a third group only biotin over 1-2 minutes. A fourth group was treated with both biotin and antibiotics for confirmed or suspected superimposed bacterial infection. The results were excellent in all groups. Skin lesions improved within 4-8 days and cleared completely within 15-30 days. Intravenous administration of biotin is recommended as less painful and less dangerous than multiple intramuscular injections.

Intrarenal mycotic (false) aneurysm secondary to staphylococcal septicemia. Report of a case detected arteriographically in a 10-month-old infant

Gross hematuria, a flank mass, and a nonfunctioning kidney were seen at excretory urography in a 10-month-old infant with staphylococcal pneumonia and septicemia. Selective renal arteriography revealed a mycotic (false) intrarenal artery aneurysm with an intrarenal and perinephric hematoma.

Immediate operative treatment for massive hemoptysis

A series of 15 patients with life threatening, massive hemoptysis is reported. Thirteen of these patients underwent immediate operative treatment with only three deaths. One died after bronchoscopic identification of the bleeding site while awaiting elective thoracotomy. The other patient left the hospital against medical advice. Immediate identification of the site of bleeding by bronchoscopy followed by thoracotomy with resection of the bleeding source, is the preferred method of managing such patients, except when there are specific contraindications to resection.