Large cysts will create air trapping and respiratory distress in infancy. In older children, they can become infected. Congenital lobar emphysema is a cystic formation in one lobe of the lung, present at birth. Infants develop distress when the cyst becomes hyperinflated with breathing. The hyperinflation may even be life-threatening.
Treatment is lobectomy.
Pneumonitis is usually easily diagnosed and treated with antibiotics. Occasionally, however, an infant or child may have symptoms and chest X-ray evidence of a pneumonitis, but the diagnosis may not be apparent. Thus, the pediatrician may ask the surgeon to perform a lung biopsy. This procedure is often helpful in pointing to the appropriate medical therapy for the problem, and can sometimes be done using video-assisted minimally invasive techniques we have developed at Children's Hospital. This is a contained space within the lung harboring infecting bacteria and fluid.