BACTEREMIC NECROTIZING PNEUMOCOCCAL PNEUMONIA IN CHILDREN

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. A ll of them were acutely ill on presentation with arterial desaturation , and they developed anemia and thrombocytosis. Two patients had pleur al effusion requiring drainage. A chest CT scan revealed segmental or lobar pulmonary liquification, which led to the diagnosis of necrotizi ng pneumonia. This finding could be demonstrated early in the course o f the disease. Subsequently, all of the patients developed cavitating lesions. With adequate antipneumococcal therapy and/or chest tube drai nage, all of the patients recovered completely; however, clinical impr ovement was prolonged: fever lasted 9 to 20 days, and length of hospit alization was 12 to 26 days. Contrary to that in adults, complete reco very is anticipated in children with bacteremic necrotizing pneumococc al pneumonia, and no invasive investigations are required.