1. Perdue, Samantha RNC-NIC
  2. Newberry, Desi DNP, NNP-BC


Background: Necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus can lead to the formation of pneumatoceles in the lungs. Standard treatment guidelines are not available due to the rarity of pneumatoceles in neonates.


Clinical Findings: Baby H. required prolonged respiratory support and supplemental oxygen to maintain appropriate oxygen saturation parameters for infants more than 34 weeks' gestation corrected. He was found to have multiple pneumatoceles in both lungs on different radiological modalities.


Primary Diagnosis: Baby H. was a former 32.2-week gestation male infant diagnosed with pneumonia caused by necrotizing methicillin-resistant Staphylococcus aureus leading to pneumatocele formation in both lungs.


Interventions: Baby H. was managed with aggressive antibiotic therapy and then was conservatively managed until he received a tracheostomy tube on day of life (DOL) 75 to prepare for discharge home.


Outcomes: Baby H. was discharged from the neonatal intensive care unit (NICU) on DOL 113 with a tracheostomy tube for prolonged mechanical ventilatory support and a gastrostomy tube for nutrition. Numerous follow-up appointments with specialists have occurred since discharge.


Practice Recommendations: While methicillin-resistant Staphylococcus aureus pneumatoceles are uncommon in the NICU setting, it is important for neonatal care providers to be aware of the causes and treatment choices currently available. Although conservative therapy is commonly utilized, it is important that nurses learn other available management strategies such as the ones highlighted in this article to best advocate for their patients.