Five-year-old in UAE saved from high-risk pneumonia infection

A critical surgery and medical procedures saved the life of a five-year-old girl, who was suffering from severe pneumonia, doctors have said.
Samah was taken to the paediatric intensive care unit (ICU) at Zulekha Hospital Dubai in a complicated state due to extensive accumulation of fluid and pus in the spaces around her lungs. Her health was declining due to the illness and required special dietetic support and physiotherapy to rebuild her strength. Over the past few weeks, she was being given breathing support, regular nebulisation and chest physiotherapy.
Dr Deepu Abraham, consultant paediatrics and neonatology, found that the pus collection exerted significant pressure on the lungs, resulting in a complete collapse. The pneumonia was so severe that a small portion of her right lung was completely destroyed. She required ventilator support to keep her lungs open. She also had a very high-grade fever despite the strong antibiotics being given.
Specialist thoracic surgeon Dr Khaldoon Abo Dakka joined Dr Abraham to help insert a drainage tube into the chest cavity to drain out the pus and expand the child's lungs back again. Complications increased due to the severity of the infection and the pus that had accumulated in several small compartments formed within the primary collection. The expert team of doctors decided to treat her with medication that was effective in breaking down the walls between these compartments of pus, making its drainage easier.
Dr Khaldoon Abo Dakka said: "One area of her lung was severely affected and had fistula formation to the extent that chances of recovery were nil. Such areas can potentially conceal and nurture bacteria and must be removed. We had to immediately perform a thoracoscopy, which is a big challenge in paediatric patients due to inability of ensuring sufficient lung isolation under anaesthesia. At the same time we had to protect the other unaffected lung and secure its ventilation throughout the procedure.
"Despite the complication, we were able to remove the irreparable segment of the lung, ensuring there were no scars at the same time," he said.
That was not all for brave Samah, who fought her way through the complications. Half-way through her antibiotic course, her blood counts started to drop, and this could have made her further vulnerable to prolonged illness and risk of secondary infections. This was managed through supportive therapy by the medical team.
Following her surgery, she developed a collapse of one lobe of her lung, due to thick lung secretions blocking the airway to that part. This hurdle was managed by opening the block with bronchoscopy, performed using a camera-assisted device that was passed into the main airway.
A month after her surgery, Samah is now out of danger and will continue to have chest physiotherapy and a prolonged course of antibiotics to completely eradicate the infection.
- reporters@khaleejtimes.com

• Dubai

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