Premium
Necrotizing pneumococcal pneumonia in children: The role of pulmonary gangrene
Author(s) -
Hsieh YuChia,
Hsiao ChengHsiang,
Tsao PoNien,
Wang JannYuan,
Hsueh PoRen,
Chiang BorLuen,
Lee WenSen,
Huang LiMin
Publication year - 2006
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20411
Subject(s) - medicine , pneumonia , gangrene , streptococcus pneumoniae , pneumococcal pneumonia , pulmonary hemorrhage , lung , surgery , antibiotics , microbiology and biotechnology , biology
Little is known about the mechanism of necrotizing pneumonia caused by Streptococcus pneumoniae in children. Pulmonary gangrene secondary to vascular thrombosis was reported in adults with necrotizing pneumococcal pneumonia. We conducted a retrospective study of 15 children with a diagnosis of necrotizing pneumococcal pneumonia at National Taiwan University Hospital to explore its association with pulmonary gangrene, based on evidence from chest computed tomography, serial chest radiographic patterns, and pathologic results. S. pneumoniae serotype 14 was the prevalent pneumococcal serotype. Overall, 63.6% of isolates were not susceptible to penicillin. One child with pneumonia caused by S. pneumoniae serotype 3 complicated by hemolytic uremic syndrome had a rapidly fatal course. An autopsy in this patient documented lung necrosis and pulmonary gangrene. Radiographic follow‐up was performed during the clinical course in 9 patients, and showed no evidence of pulmonary gangrene. Four children had no radiographic follow‐up. The relationship between pulmonary gangrene and necrotizing pneumonia was unclear in the remaining one. In conclusion, necrotizing pneumococcal pneumonia may be infrequently associated with pulmonary gangrene in children. Pediatr Pulmonol. 2006; 41: 623–629. © 2006 Wiley‐Liss, Inc.