Am. J. Respir. Crit. Care Med., Vol 149, No. 1, Jan 1994, 242-244.
Bacteremic necrotizing pneumococcal pneumonia in children
E Kerem, Y Bar Ziv, B Rudenski, S Katz, D Kleid and D Branski
Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.
Necrotizing pneumonia, massive necrosis of lung tissue, is a serious, often
fatal, complication of lobar pneumonia. Four children 1.3 to 7.5 yr of age
were hospitalized with bacteremic pneumococcal pneumonia. All of them were
acutely ill on presentation with arterial desaturation, and they developed
anemia and thrombocytosis. Two patients had pleural effusion requiring
drainage. A chest CT scan revealed segmental or lobar pulmonary
liquification, which led to the diagnosis of necrotizing pneumonia. This
finding could be demonstrated early in the course of the disease.
Subsequently, all of the patients developed cavitating lesions. With
adequate antipneumococcal therapy and/or chest tube drainage, all of the
patients recovered completely; however, clinical improvement was prolonged:
fever lasted 9 to 20 days, and length of hospitalization was 12 to 26 days.
Contrary to that in adults, complete recovery is anticipated in children
with bacteremic necrotizing pneumococcal pneumonia, and no invasive
investigations are required.
