A child with pyoderma becomes toxic and presents with respiratory distress. His chest radiograph shows patchy areas of consolidation and multiple bilateral thin walled air containing cysts. The most likely etiological agent in this case is?
Ans. is 'b' i.e., Staphylococcus aureus o Pneumonia with pneumatoceles (multiple thin walled air containing cysts) is s/o staphylococcal pneumonia. o Clinical features of staphylococcal pneumonia The illness usually follows upper respiratory tract infection, pyoderma or other associated purluent disease. Besides the usual features of pneumonia child has fever and anorexia and is listless and irritable. Abdomen is usually distended due to septicemia and ileus. Cyanosis may be present Progression of the symptoms and signs is rapid. o Diagnosis? The diagnosis of staphylococcal pneumonia is suspected in a newborn or an infant with respiratory infection who has evidence of staphylococcal infection elsewhere in the body (here it is pyoderma). Complications such as pyopneumothorax and pericarditis are highly suggestive of diagnosis (Empyema in child below 2 yrs of age is nearly always staphylococcal in etiology) Presence of Pneumatoceles is considered pathognomic for staphylococcal pneumonia (It can also be seen in pneumonia due to Rlebseilla) o Note: Pyoderma or impetigo is a superficial infection of the skin caused primarily by group A streptococci and occasionally by other streptococci and staphylococci. o Tachypnea is the most consistant clinical manifestation of pneumonia.
Mycobacterium tuberculosis
Staphylococcus aureus
Mycobacterium avium intracellulare
Pneumocystis carinii