Definition: defined as cystic airspace within the lung which characteristically increases in size over days-weeks (probably due to ball-valve air trapping mechanism), but eventually resolves
Typically associated with infection (usually Staph Aureus)
Pneumocystis Jirovecii (see Pneumocystis Jirovecii, [[Pneumocystis Jirovecii]]): cystic lesions are usually seen in HIV-associated cases, are more common in upper lobes, and range in size from 1-5 cm
Tension Pneumatocele (Compression of Adjacent Structures): including compression of lung or mediastinal structures -> may be acute and life-threatening
Secondary Infection of Pneumatocele: may occur
Pneumothorax: may occur when pneumatocele ruptures into the pleural space
References
Observation: usually indicated, as pneumatoceles typically resolve sponatenously over weeks-months
However, cases with persistence up to 3 years have been reported
Pneumatocele Decompression: may be required in some cases
Tube Decompression: while may be acutely beneficial (with rapid decompression), may pose a risk for persistent bronchopleural fistula
Surgical Excision
Treatment of Associated Pneumothorax: if present
References
The origin of lung cysts in childhood. Arch Dis Child. 1951;26:504-529
On the natural regression of pulmonary cysts during early infancy. Pediatr. 1953;11:48-64
Staphylococcal pneumonia in infancy and childhood: Analysis of 75 cases. JAMA. 1958;168:6-16
Subpleural emphysema complicating staphylococcal and other pneumonias. J Pediatr. Aug 1972;81(2):259-66
Pneumococcal pneumonia with pneumatocele formation. Am J Dis Child. Nov 1978;132(11):1091-3
Solitary cavities of the lungs: diagnostic implications of cavity wall thickness. Amj J Roentgenol 1980; 135: 1269-271
Haemophilus influenzae type B pneumonia with pneumatocele formation. Clin Pediatr (Phila). Feb 1980;19(2):151-2
Persistent postpneumonic pneumatoceles in children. Chest. Mar 1981;79(3):359-61
Staphylococcal pneumonia in infants and children. Pediatr Infect Dis. Jan-Feb 1982;1(1):19-23
Pneumatocele in infants and children. Report of 12 cases. Clin Pediatr (Phila). Jun 1983;22(6):420-2
Pneumatocele formation in adult pneumonia. Chest. Oct 1987;92(4):717-20
Pulmonary pneumatocele: pathology and pathogenesis. AJR Am J Roentgenol. Jun 1988;150(6):1275-7
Traumatic pneumatocele. J Pediatr Surg. Dec 1992;27(12):1523-4
Pneumatocele complicating hyperimmunoglobulin E syndrome (Job’s Syndrome). Ann Thorac Surg. Dec 1992;54(6):1206-8
Primary staphylococcal pneumonia in childhood: a review of 69 cases. J Paediatr Child Health. Dec 1992;28(6):447-50
Staphylococcal pneumonia in childhood: will early surgical intervention lower mortality?. Pediatr Pulmonol. Aug 1995;20(2):83-8
Traumatic pneumatoceles in an infant: case report and review of the literature. Eur J Pediatr Surg. Apr 1996;6(2):104-6
Percutaneous catheter drainage of tension pneumatocele, secondarily infected pneumatocele, and lung abscess in children. Crit Care Med. Feb 1996;24(2):330-3
Serratia marcescens pneumonia, empyema and pneumatocele in a preterm neonate. Pediatr Infect Dis J. Oct 1997;16(10):1003-5
Management of tension pneumatocele with high-frequency oscillatory ventilation. Chest. Jan 2002;121(1):284-6
Mayo Clin Proc 2003; 78: 744-752
Pneumatoceles in postpneumonic empyema: an algorithmic approach. J Pediatr Surg. Jul 2005;40(7):1111-7
Complicated pneumonias with empyema and/or pneumatocele in children. Pediatr Surg Int. Feb 2006;22(2):186-90
Community-associated methicillin-resistant Staphylococcus aureus: reconsideration of therapeutic options. Curr Infect Dis Rep. Jan 2006;8(1):23-30