Abstract Ref Number = APCP993
PNEUMOTHORAX IN NEWBORN CAUSED OF PNEUMONIA
Aldora Jesslyn Oentari,Daniel Susatyo Wirawan,Iman Martafani
pribadi Dr Kanujoso Djatiwibowo Hospital, Balikpapan, East Borneo, Indonesia
Background : Pneumothorax is a life threatening condition, can occur in the newborn spontaneously or idiopathic or secondary, if not recognized may have fatal consequences. Happened because of epithelium damage from air accumulation outside the lungs, caused of transpulmonary pressure that exceeds the capacity of the alveoli and airway strains that do not have cartilage tissue. Risk factors in neonates are hyaline membrane disease (HMD), mechanical ventilation, meconium aspiration syndrome (MAS), congenital malformation, sepsis, and pneumonia. If considerable distress persists, continuous drainage should be provided.
Case Presentation Summary : An eight hours old male full term newborn, birth weight 3890 gr, born with APGAR score 7/9, DOWNE score 0, from G2P1A0 mother with leukocytosis risk factor, no old parturion history. Presented with dyspnoea, nasal flaring, intercostal retraction, respiratory rate 68x/minutes, SpO2 82%, acyanotic. Patient transferred to NICU. Laboratory examination showed leukocytosis. Chest x-rays revealed right side pneumothorax and pneumonia. CPAP, IV line and antibiotic were given. Then, water sealed drainage procedure was performed. Patient was discharge in good condition.
Learning Points/Discussion : In aterm neonate, pneumothorax occurs more frequently in MAS, mechanical ventilation and is associated with resuscitation, pneumonia, diaphragmatic hernia, and sepsis. In pneumonia, histopathologically there are three forms of abnormalities in lung tissue. First, the hyaline membrane form is a nonspecific response that shows lung tissue damage due to surfactant deficiency, pneumonia, and oxygen therapy. Second, suppurative pneumonia occurs necrosis of the pulmonary parenchyma, the formation of microabsions and partial blockage of the terminal bronchioles resulting in thinning of the airway wall. Third, interstitial pneumonitis develops inflammation of pulmonary interstitial tissue, edema, mononuclear infiltration, and septal hyperplasia.
Keywords: Pneumothorax Pneumonia Newborn