Bacteremic necrotizing pneumococcal pneumonia in children

Am J Respir Crit Care Med. 1994 Jan;149(1):242-4. doi: 10.1164/ajrccm.149.1.8111589.


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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / blood
  • Bacteremia / complications*
  • Bacteremia / diagnosis
  • Bacteremia / therapy
  • Chest Tubes
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Necrosis
  • Pneumococcal Infections / blood
  • Pneumococcal Infections / complications*
  • Pneumococcal Infections / diagnosis
  • Pneumococcal Infections / therapy
  • Pneumonia, Pneumococcal / complications*
  • Pneumonia, Pneumococcal / diagnosis
  • Pneumonia, Pneumococcal / pathology
  • Pneumonia, Pneumococcal / therapy
  • Streptococcus pneumoniae*
  • Tomography, X-Ray Computed


  • Anti-Bacterial Agents