A Complex Pediatric Case: Cerebral Palsy Complicated by Severe Pneumonia and Atelectasis
DOI:
https://doi.org/10.21776/ub.jkb.2022.033.03.11Keywords:
Atelectasis, cerebral palsy, pathophysiology, pneumoniaAbstract
Cerebral palsy (CP) is a non-progressive motor and cognitive disorder resulting from brain injury during development. Cerebral palsy (CP) promotes the development of respiratory disorders, including pneumonia and atelectasis. In this case, an 8-year-old male with cerebral palsy presented with complaints of shortness of breath, intermittent fever, productive cough, and decreased appetite. His respiratory rate was 28 beats per minute, SpO2 was 85%, and temperature was 37°C. Chest X-ray showed right pleural effusion with atelectasis, pneumonia in the left lung, emphysematous lung, and thoracic scoliosis. Bronchoscopy examination showed total atelectasis in the middle lobe of the right lung, with Streptococcus mitis or Streptococcus oralis identified through microbiological examination. Individuals with CP are susceptible to respiratory diseases due to neuromuscular impairment of the laryngeal muscles. This impairment can progress to atelectasis and pneumonia, representing the most common respiratory complications in CP.
Downloads
References
1. Kuo TJ, Hsu CL, Liao PH, Huang SJ, Hung YH, and Yin CH. Nomogram for Pneumonia Prediction among Children and Young People with Cerebral Palsy: A Population-Based Cohort Study. PLoS One. 2020; 15(7): E0235069.
2. Pozzo CCD, Seibert PA, and Fujisawa DS. Children with Pulmonary Atelectasis: Clinical Outcome and Characterization of Physical Therapy. Acta Scientiarum Health Science. 2013; 35(2): 169–173.
3. Proesmans M. Respiratory Illness in Children with Disability: A Serious Problem? Breathe 2016; 12(4): e97–e103.
4. Yoon SY, Kim YW, and Choi JY. Pulmonary Rehabilitation in a Patient with Bronchiectasis and Underlying Cerebral Palsy: A Case Presentation. PM&R 2018; 10(5): 548–551.
5. Patel DR, Neelakantan M, Pandher K, and Merrick J. Cerebral Palsy in Children: A Clinical Overview. Translational Pediatrics. 2020; 9(S1): S125-S135.
6. Duman K. Cerebral Palsy: An Overview. Hamidiye Medical Journal. 2022; 3(1): 1–6.
7. Jones MW, Morgan E, Shelton JE, and Thorogood C. Cerebral Palsy: Introduction and Diagnosis (Part I). Journal of Pediatric Health Care. 2007; 21(3): 146–152.
8. Dias BLS and De Lima FM. Respiratory System Impairments in Children with Cerebral Palsy: Outpatient Surveillance, Diagnosis, and Treatment. Medical Research Archives. 2021; 9(11): 1-25.
9. Marpole R, Blackmore AM, Gibson N, Cooper MS, Langdon K, and Wilson AC. Evaluation and Management of Respiratory Illness in Children with Cerebral Palsy. Front Pediatric. 2020; 8: 1-13.
10. Braverman JM. Airway Clearance Dysfunction Associated with Cerebral Palsy: An Overview. Advanced Respiratory 2001; 800: 4224-4229.
11. Pitts T. Airway Protective Mechanisms. Lung. 2013; 192(1): 27–31.
12. Hafifah CN, Setyanto DB, Putra ST, Mangunatmadja I, Sari TT, and Wulandari HF. Gross Motor Dysfunction as a Risk Factor for Aspiration Pneumonia in Children with Cerebral Palsy. Pediatric Indonesia 2017; 57(5): 229-233.
13. Boel L, Pernet K, Toussaint M, et al. Respiratory Morbidity in Children with Cerebral Palsy: An Overview. Developmental Medicine and Child Neurology. 2019; 61(6): 646–653.
14. Colomba C, Garbo V, Boncori G, et al. Streptococcus Mitis as a New Emerging Pathogen in Pediatric Age: Case Report and Systematic Review. Antibiotics 2023; 12(7): 1-14.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jurnal Kedokteran Brawijaya

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).