Source: Annual Congress 2002 - Miscellaneous respiratory infections in children

Abstract

Right middle lobe syndrome (RMLS) is a recurrent or chronic (at least one month[scquote]s duration) collapse of the RML and/or lingula and is characterized by a spectrum of clinical and pathological lesions ranging from recurrent atelectasis or pneumonias to bronchiectasis.
The aim of the study was to evaluate the clinical history and the outcome of the RMLS in our pediatric Department.
Out of 60 pneumonias, 15 cases of asthma, 29 cases of bronchiolitis, 1 foreign body inhalation admitted over a period of two years (from January 2000 to December 2001), RMLS[scquote]s were considered, with particular attention to the personal history and pathological findings.
Three children with RMLS [two males, mean age 11.3 years (range: 5-17 yrs)] were admitted to our Department for chronic cough, fever, purulent rhinorroea, dyspnoea and unsuccessful treatments (inhaled/oral corticosteroids and oral antibiotics). Chest roentgenograms (CX-r) were typical in two patients and suggestive of pneumothorax (PNX) in the third one. All patients received antibiotics (oral amoxicillin in the first two, parenteral ceftriaxon in the third one) and chest physiotherapy (CPT), started immediately in two patients and after the reduction of the PNX in the third one. The clinical conditions improved at once in all patients, as confirmed by the CX-r.
In conclusion, CX-r is the first helpful investigation in the assessment of the chronic cough, which can be the only symptom of the RMLS. CPT remains one of the most important non invasive options in the treatment of the recent or persistent RMLS of the pediatric age. As found in the literature, the complete resolution of uncomplicated RMLS was observed within three months.

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Citations should be made in the following way:
M. Don, M. Canciani, L. Fasoli, F. De Franco, M. Cossettini, P. Melli, F. Braida, A. Tenore (Udine, Italy). Right middle lobe syndrome in children: a clinical review. Eur Respir J 2002; 20: Suppl. 38, 2099

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