- Pleuro-pulmonary complications in patients with chistic fibros
Pleuro-pulmonary complications in patients with chistic fibros
Paediatric Surgery.2017.4(57):28-34; doi 10.15574/PS.2017.57.28
Gudumac E., Şciuca S., Selevestru R., Balaneţchi L.
University of Medicine and Pharmacy «Nicolae Testemitanu», Chisinau, Republic of Moldova
IMSP Mother and Child Institute, Clinic of Pneumology, Chisinau, Republic of Moldova
Children Emergency Hospital, Cluj Napoca, Romania
Cystic fibrosis (CF) is an autosomal-recessive genetic disease characterized by a clinical triad: chronic pulmonary disease (chronic cough with purulent expectoration, dyspnoea, cyanosis, digital hippocratism), pancreatic insufficiency with maldigestion, malabsorption (fecal mass with lipid inclusions, fetide, bulky) weighting and increased content of chlorides in the sweat. In the study are evaluated the clinic and imagistic sings of the lungs in 80 patients with CF by imagistic techniques. The main clinical manifestations in CF patients under study have been recorded in episodes of tremendous bronchial obstruction that is manifested by recurrent wheezing, persistent cough syndrome. The progressive evolution of the pulmonary pathological process was determined by resistant germs such as Ps. aerugenosa, St. maltophilia, S. aureus, B. cepia complex, which accelerated the destructive processes of the pulmonary parenchyma, and contributes to the spread of pulmonary fibrosis, bronchiectasis, emphysema, pulmonary destruction, focal or diffuse fibrosis, pleurisy, pneumathorax, all seen and diagnosed in imaging exams. During the surveillance, the following complications were identified – pneumothorax, pleurisy (requiring toracocentesis), air bubbles, pulmonary empyema, pulmonary destruction, that developed in CF patients with exacerbations of S. aureus, Ps. aeruginosa, B. cepacia lung infections. Synthesis of literature data and clinical experience has made it possible to optimize treatment programs for patients with CF to reduce the risk of progressive adverse evolutions, pleuro-pulmonary complications. Contemporary, long-term treatment in CF offers better quality of life, especially gene therapy.
Key words: cystic fibrosis, pleuro-pulmonary complications, children.