Five-year-old saved from High-risk Pneumonia Infection
Early and prompt treatment of chest infections crucial to protect children
Zulekha Hospital experts extend instant critical care to treat complications

Dubai, United Arab Emirates, 1 July 2019: Five-year-old Samah had developed severe pneumonia and was brought into the pediatric 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 nebulization and chest physiotherapy. 

On diagnosis Dr Deepu Abraham Consultant Pediatrics & 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.

Samah with her father and treating doctors

Specialist Thoracic Surgeon, Dr Khaldoon Abo Dakka joined Dr Abraham in the persistent treatment procedure 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. This made its drainage by a chest tube practically very tricky. 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 pediatric patients due to the inability to 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.” 

The administration of medication through the chest drain to break down the pus compartments in her chest, along with the presence of infected lung tissue distinctly increased the risk of bleeding during her thoracoscopic surgery. Thanks to the thoracoscopic method, which was less invasive than open surgery and the skills and expertise of the surgeon, the bleeding complications were minimal in this case. 

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 make her further vulnerable to prolonged illness and risk of secondary infections. This was again promptly detected and 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.

Commenting on the precautions to be taken by parents when children develop Pneumonia Dr Abraham remarked, “The incidence of pneumonia and complications are not uncommon in children, but lung conditions with such complexity and severity are. Early and prompt treatment of bacterial chest infections is crucial.  At the same time treating experts must take care to avoid unnecessary excessive use of antibiotics. It is a tough task for clinicians to strike this balance and we are glad to have successfully managed this complicated condition with utmost caution”

Intensive care unit admission of a child is a very distressing experience for any parent. Despite protracted and critical nature of the illness, the stress of their child undergoing multiple procedures, and occasional clinical uncertainties, the parents displayed remarkable calmness and presence of mind. This task would not have been accomplished without the unwavering faith the parents placed on the treating medical team. 

Dr Abraham added, “It is very critical that all treating doctors are aligned and work together in such cases. Leaving no stone unturned in offering our best to the patient, regular inputs from our colleagues Specialist Pediatrics Dr. Dhiraj Sidagonda Shedabale and Dr Ahmad Ismail Al Dahshan and brilliant nursing care helped us attain this good outcome for Samah.”

About Zulekha Healthcare Group www.zulekhahospitals.com 

Zulekha Healthcare Group is a Superbrand and among the forerunners in UAE healthcare. Today the Zulekha Healthcare Group includes two multidisciplinary hospitals in Dubai and Sharjah, as well as four UAE medical centres and three pharmacies providing specialised treatments in over 30 disciplines. The group also has a multidisciplinary hospital in India – Alexis. Zulekha Hospital has received extensive recognition for its commitment towards quality care and sustainable business practices, and recently received the prestigious Dubai Quality Award for the second time in four years, underling a commitment to providing high-quality healthcare to patients and society. 

Media Contact:
Sameena Khanam – Senior Manager PR and Communications
Zulekha Hospitals
+971 6 5069254
skhanam@zulekhahospitals.com