Pediatric Necrotizing Pneumonia: A Case Report

Abstract

Necrotizing pneumonia (NP) is characterized by extensive damage to the lung parenchyma through the action of proteolytic enzymes and an exacerbated inflammatory response to an infectious process. Although rare, there has been an increase in the number of cases in recent years, with high morbidity.  A 4-year-old male patient with a previous diagnosis of viral pneumonia was admitted to hospital with a cough, high fever and chest pain. On admission, he was prostrate, feverish and tachypneic. Pulmonary auscultation revealed a decreased vesicular murmur in the right hemithorax. A chest X-ray showed bronchopneumonia associated with pleural effusion on the right. Broad-spectrum antibiotic therapy was introduced and hemithorax drainage was performed. During hospitalization, the patient showed partial clinical and radiological improvement, maintaining a high fever. The NP was detected after a computerized tomography (CT) scan, and surgical treatment was chosen. The condition usually has a long evolution and prolonged hospitalization, and can evolve with complications such as pleural effusion, bronchopleural fistula and sepsis. However, when properly recognized and treated, it has a good overall survival rate. Therefore, it can be seen that NP is a serious complication, and the literature still lacks data, making further studies on the subject necessary. Thus, this report aims to help with early recognition and management, as well as encouraging further research.