title: The Clinical Courses of Patients with Congenital Cystic Adenomatoid Malformation Complicated by Pneumonia.
abstract: OBJECTIVE
  We evaluated the clinical characteristics and courses of patients with congenital cystic adenomatoid malformation (CCAM) complicated by pneumonia.
  
  
  METHODS
  We retrospectively reviewed the records of 19 adult patients with surgically confirmed CCAM between March 2005 and July 2013.
  
  
  RESULTS
  Eighteen of nineteen patients presented with acute pneumonia symptoms and signs, and inflammatory markers were elevated. On chest computed tomography, all 18 patients had parenchymal infiltration around cystic lesions, 17 (94%) had an air-fluid level, and 2 (11%) had pleural effusion. After antibiotics treatment for a median of 22 days prior to surgery, all acute pneumonia symptoms and signs disappeared in 17 (94%) patients at a median of 10 days. Improvements and normalization of inflammatory marker levels, occurred in 17 (94%) and 9 (50%) patients at medians of 8 and 17 days, respectively. Radiological improvement was evident in 11 (61%) patients, at a median of 18 days, of these patients, partial radiological improvement occurred in 10 (56%) and complete radiological resolution in only 1 (6%). One patient (6%) did not improve in terms of clinical, laboratory, or radiological findings despite antibiotic treatment for 13 days. Consequently, after 17 (94%) elective and 1 (6%) emergency surgeries, all patients improved without development of complications.
  
  
  CONCLUSIONS
  We described the clinical characteristics and courses of patients with CCAM complicated by pneumonia, and showed that surgery may be performed safely after clinicolaboratory improvement is attained upon antibiotic treatment, even in the absence of complete radiological resolution.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Jhun
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Kang
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Thoracic Surgery, The Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea. leejieun77@gmail.com.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Lee
mesh_terms: D000328:Adult; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination; D010996:Pleural Effusion; D011014:Pneumonia / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Antibiotic treatment; congenital cystic adenomatoid malformation; surgical resection