[Spontaneous pneumothorax in children]

[A case of recurrent spontaneous pneumothorax]

Spontaneous pneumothorax is a rare disease at paediatric age and in most cases is associated to predisposing factors. The authors present a case of spontaneous pneumothorax in a 9 year-old child with a history of prematurity and mechanical ventilation at neonatal stage. In spite of clinical and radiological improvement after pleural drainage, pneumothorax recurred three months later and emphysema was identified, leading to surgery. This case is important due to the rarity of the disease in this age group and its possible relation to prior neonatal medical history.

A case of Langerhans cell histiocytosis presented with pneumothorax

Pneumothorax (PTX) is an unusual complication of Langerhans cell histiocytosis (LCH) in childhood. Spontaneous PTX is rare in childhood, and it is very rare in infancy. There are no specific recommendations for the treatment of PTX from LCH described in the literature. We are presenting a 19-month-old boy, who suddenly developed left-sided PTX with infiltrations in both lungs. He presented with PTX and skin lesions. He had a prolonged cardiac arrest, and although resuscitation was successful he required continuing ventilatory support (intermittent positive-pressure ventilation). Because he suddenly developed right-sided PTX and died on the second day of the admission, his LCH diagnosis was made only postmortem. So, he did not receive chemotherapy. It is likely that intermittent positive-pressure ventilation during the operation induced the development of much more multiple lung bullae, which subsequently ruptured, and/or it facilitated the development of the right-sided PTX. The patients with PTX and skin lesions, including babies, most likely have LCH and specific chemotherapy should be started in emergency, even before the final diagnosis is achieved.

Spontaneous pneumothorax in two cats with small airway disease

Two adult domestic shorthair cats were examined because of pneumothorax. Neither had a history of trauma, and spontaneous pneumothorax secondary to small airway disease was diagnosed. In both cats, treatment consisted of thoracocentesis for evacuation of air and administration of anti-inflammatory agents. One cat had multiple episodes of pneumothorax and eventually died; the other had only a single episode of pneumothorax. Small airway disease should be considered as a potential underlying cause in cats that develop spontaneous pneumothorax. Additionally, the potential for pneumothorax should be considered in cats with small airway disease, particularly when clinical signs suddenly become much worse.