Pulmonary abscess in an infant treated with ultrasound-guided drainage

Abstract Lung abscesses are very rare in infants, and most cases are cured by antibiotic administration. However, surgical treatment was necessary in our case when deterioration was seen despite using antibiotics for 1 week. A 5-week-old male infant showed high levels of inflammatory biomarkers on laboratory tests. Computed tomography (CT) revealed a fluid-filled lesion about 34 × 28 mm with air-fluid level arising from the left upper lobe. We initiated antibiotic treatment; however, after 1 week of antibiotic treatment, a chest X-ray showed no improvement. Under ultrasound guidance, we punctured under the left scapula into the abscess space. Purulent discharge and air were aspirated, and we placed a pigtail catheter into the abscess space. The air leak continued for 2 weeks after drainage; therefore, we replaced the pigtail catheter with a straight and thinner catheter. Five days after replacement of the catheter, the air leak had stopped. Six weeks after drainage, chest X-ray and CT showed no lung abscess or pneumothorax, and he was discharged soon after. There had been no recurrence at the 3-month follow-up. In cases of lung abscesses resistant to antibiotic treatment, we should consider the option of percutaneous drainage as a minimally invasive surgical approach. (197 words).