Abstract
Background: Necrotizing pneumonia (NP) is a rare complication of pneumonia in children which presents with liquefaction, abscesses and cavitation of lung tissue. Clinical characteristics include a severe presentation, the need of early broad-spectrum antibiotics and sometimes a surgery approach. Despite its importance, there are few studies concerning NP in children in Spain.
Objectives: Describe the epidemiology, etiology, management, and outcomes of children diagnosed with NP in a tertiary hospital in Spain.
Methods: Retrospective study of NP cases from January 2003-December 2020. Clinical presentation, laboratory findings, hospital course and long-term follow-up were analyzed.
Results: Twenty-seven cases of NP were identified with a steady annual incidence (2-3 cases per year). Median age of presentation was 3 years. All patients were immunocompetent and were correctly vaccinated. A total of 17 (63%) cases had pleural effusion which required pleural drainage, associated or not with consolidations, cavities and abscesses in lung parenchyma. A pathogen was detected in 13 (48%) patients: 6 (22%) S. pneumoniae, 3 (11%) S. aureus, 2 (7%) non-typable Haemophilus, 1 (3%) Adenovirus and 1 (3%) S. mitis. Hospitalization lasted a median of 22 days. None of our patients required surgical management. Obliterating bronchiolitis was diagnosed in one patient after a NP caused by Adenovirus. The other 26 patients fully recovered.
Conclusions: S. pneumoniae remains the predominant pathogen related to NP even after the introduction of pneumococcal conjugate vaccine (PCV7 and 13). Despite the morbidity, pulmonary damage and long hospitalisations, the long-term outcome of our cases following NP was excellent.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1967.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021