Pneumatocele in infants and children. Report of 12 cases.

Pneumatoceles were found in 2.4 per cent of 493 infants and children with pneumonia. In all cases, attempts were made to establish the etiology by means of blood cultures and of deep tracheal aspirations or pleural punctures, when indicated. A definite cause was established in 9 of 12 cases. Seven were due to infection: in two Hemophilus influenzae was involved; two others were due to Pseudomonas aeruginosa; and Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pneumoniae were each isolated in one case. Two pneumatoceles were seen following kerosene ingestion. A coagulase negative staphylococcus isolated only on blood culture in one other child may have been related to the illness. Two patients experienced spontaneous pneumothorax and died of progressive respiratory failure due to enlargement of the pneumatocele, but all the other patients recovered without complication. Pneumatoceles in childhood can result from a variety of bacterologic infections as well as from kerosene ingestion.