Necrotizing pneumococcal pneumonia in children: The role of pulmonary gangrene

被引:48
作者
Hsieh, Yu-Chia
Hsiao, Cheng-Hsiang
Tsao, Po-Nien
Wang, Jann-Yuan
Hsueh, Po-Ren
Chiang, Bor-Luen
Lee, Wen-Sen
Huang, Li-Min
机构
[1] Natl Taiwan Univ Hosp, Dept Pediat, Taipei 100, Taiwan
[2] Natl Taiwan Univ Hosp, Dept Pathol, Taipei 100, Taiwan
[3] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
[4] Natl Taiwan Univ Hosp, Dept Lab Med, Taipei 100, Taiwan
[5] Taipei Med Univ, Wan Fang Hosp, Dept Med, Sect Infect, Taipei, Taiwan
关键词
Streptococcus pneumoniae; necrosis; thrombosis; pneumonia;
D O I
10.1002/ppul.20411
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Little is known about the mechanism of necrotizing pneumonia caused by Streptococcus pneumoniae in children. Pulmonary gangrene secondary to vascular thrombosis was reported in adults with necrotizing pneumococcal pneumonia. We conducted a retrospective study of 15 children with a diagnosis of necrotizing pneumococcal pneumonia at National Taiwan University Hospital to explore its association with pulmonary gangrene, based on evidence from chest computed tomography, serial chest radiographic patterns, and pathologic results. S. pneumoniae serotype 14 was the prevalent pneumococcal serotype. Overall, 63.6% of isolates were not susceptible to penicillin. One child with pneumonia caused by S. pneumoniae serotype 3 complicated by hemolytic uremic syndrome had a rapidly fatal course. An autopsy in this patient documented lung necrosis and pulmonary gangrene. Radiographic follow-up was performed during the clinical course in 9 patients, and showed no evidence of pulmonary gangrene. Four children had no radiographic follow-up. The relationship between pulmonary gangrene and necrotizing pneumonia was unclear in the remaining one. In conclusion, necrotizing pneumococcal pneumonia may be infrequently associated with pulmonary gangrene in children.
引用
收藏
页码:623 / 629
页数:7
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