Necrotizing Pneumonia and Its Complications in Children

  • Katarzyna Krenke
  • Marcin Sanocki
  • Emilia Urbankowska
  • Grażyna Kraj
  • Marta Krawiec
  • Tomasz Urbankowski
  • Joanna Peradzyńska
  • Marek Kulus
Chapter
First Online:
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 857)

Abstract

Necrotizing pneumonia (NP) is an emerging complication of community acquired pneumonia (CAP) in children. This study aimed at the evaluation of etiology, clinical features, treatment, and prognosis of NP. The institutional database of children with CAP treated between April 2008 and July 2013 was searched to identify children with NP. Then, data on the NP characteristics were retrospectively reviewed and analyzed. We found that NP constituted 32/882 (3.7 %) of all CAPs. The median age of children with NP was 4 (range 1–10) years. The causative pathogens were identified in 12/32 children (37.5 %) with Streptococcus pneumoniae being the most common (6/32). All but one patient developed complications: parapneumonic effusion (PPE), pleural empyema or bronchopleural fistula (BPF), which required prompt local treatment. The median duration of hospital stay and antibiotic treatment was 26 (IQR 21–30) and 28 (IQR 22.5–32.5) days, respectively. Despite severe course of the disease no deaths occurred. A follow-up visit after 6 months revealed that none of the patients presented with any signs and symptoms which could be related to earlier pneumonia. Chest radiographs showed complete or almost complete resolution of pulmonary and pleural lesions in all patients. We conclude that necrotizing pneumonia is a relatively rare but severe form of CAP that is almost always complicated by PPE/empyema and/or BPF. It can be successfully treated with antibiotics and pleural drainage without major surgical intervention.

Keywords

Bronchopleural fistula Community acquired pneumonia Empyema Pediatrics 
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Notes

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Katarzyna Krenke
    • 1
  • Marcin Sanocki
    • 1
  • Emilia Urbankowska
    • 1
  • Grażyna Kraj
    • 1
  • Marta Krawiec
    • 1
  • Tomasz Urbankowski
    • 2
  • Joanna Peradzyńska
    • 3
  • Marek Kulus
    • 1
  1. 1.Department of Pediatric Pneumology and AllergyMedical University of WarsawWarszawaPoland
  2. 2.Department Internal Medicine Pneumology and AllergologyMedical University of WarsawWarszawaPoland
  3. 3.Department of EpidemiologyMedical University of WarsawWarszawaPoland

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