Abstract:
OBJECTIVE:Necrotizing pneumonia (NP) is recently recognized as a complication of pneumonia. The data on NP are scant from developing world and we aimed to describe the characteristic features of NP in our children. STUDY DESIGN:Single center retrospective cohort analysis. PATIENT SELECTION:Institutional database of children treated for pneumonia between September 2014 and May 2018 was searched to identify children with NP. METHODS:The demographic characteristics, laboratory results, and clinical information were recorded for patients selected as NP and analyzed. RESULTS:In total, 10 patients (3.7%) of NP were identified out of 272 patients with pneumonia. Median age was 3 years (range: 3 months to 12years). All cases had severe respiratory distress and 70% required mechanical ventilation and inotropic support. The causative pathogens were identified in 6/10 children (60%) with Staphylococcus aureus being most common (4/10). Pleural effusion and pneumothorax were seen in six cases. Four cases had bilateral pleural effusion and three had bilateral pneumothorax. Intercostal drainage (ICD) was placed in 70% and bilateral ICD was placed in 40% cases. Bronchopleural fistula (BPF) developed in two cases and one had bilateral BPF. Median [inter quartile range] ICD days and hospital stay were 9 (6-14) and 13.5 (7.5-18.5) days, respectively. Mean (±SD) total antibiotic (in hospital plus outpatient) days were 28.8 ± 9.6 days. Four cases had airway hemorrhage and in three cases this was massive and fatal. CONCLUSION:NP is a relatively rare but severe complication of pneumonia distinct from pediatric acute respiratory distress, pleural effusion and empyema. Airway hemorrhage is the most fatal complication.
journal_name
J Trop Pediatrjournal_title
Journal of tropical pediatricsauthors
Sharma PK,Vinayak N,Aggarwal GK,Srivastava RD,Aggarwal PK,Kushwaha ASdoi
10.1093/tropej/fmaa027subject
Has Abstractpub_date
2020-12-01 00:00:00pages
637-644issue
6eissn
0142-6338issn
1465-3664pii
5849168journal_volume
66pub_type
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journal_title:Journal of tropical pediatrics
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journal_title:Journal of tropical pediatrics
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of tropical pediatrics
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journal_title:Journal of tropical pediatrics
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