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203742

Necrotizing Pneumonia: A Case Report on a Rare Complication of Respiratory Syncytial Virus Pneumonia

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Last updated: 03 Jan 2025

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Abstract

Background: Necrotizing pneumonia is uncommon in children compared to adults. It is characterized by progressive pneumonic illness in a previously well child despite appropriate antibiotic treatment. This further leads to areas of necrosis and liquefaction of the consolidated lung tissue, which may be complicated by solitary, multiple, or multiloculated radiolucent foci, bronchopleural fistulas, and intrapulmonary abscess formation. Necrotizing pneumonia is usually secondary to Pneumococcus, Staphylococcus aureus, or, less commonly, Pseudomonas aeruginosa infections, and is rarely seen secondary to viruses. Although cavitary necrosis manifests as a severe disease, most children exhibit complete recovery even without surgical treatment and have normal chest radiographs in the long term. Case report: In this report, a 3-year-old immunocompetent patient developed pleural effusion and empyema and underwent ultrasound-guided drainage without clinical improvement, leading to necrotizing pneumonia secondary to a respiratory syncytial virus and requiring video-assisted thoracoscopic surgery. We initiated conservative treatment with prolonged antibiotics, ventilator support, and analgesics. Conclusion: Early surgical intervention in cases of necrotizing pneumonia is challenging, and it is unknown whether it is superior to medical management. Repeating chest radiographs should be considered in cases of changes in the patient's status or whenever there is a delay in recovery.  

DOI

10.21608/ejhm.2021.203742

Keywords

Necrotizing pneumonia, Respiratory syncytial virus, Video-assisted thoracoscopic surgery

Authors

First Name

Rotana

Last Name

Hammad

MiddleName

-

Affiliation

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Email

rotana.hammad@hotmail.com

City

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Orcid

-

First Name

Khourshed

Last Name

Tewfik

MiddleName

-

Affiliation

-

Email

khourshed@gmail.com

City

-

Orcid

-

First Name

Shahinaz

Last Name

Munshi

MiddleName

-

Affiliation

-

Email

shahinaz_munshi@windowslive.com

City

-

Orcid

-

First Name

Mohammed

Last Name

Felemban

MiddleName

-

Affiliation

-

Email

dr_m_felemban@hotmail.com

City

-

Orcid

-

Volume

85

Article Issue

2

Related Issue

28296

Issue Date

2021-10-01

Receive Date

2021-11-08

Publish Date

2021-10-01

Page Start

3,695

Page End

3,699

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 85_Issue 2_Pages 3695-3699.pdf

PDF . 724.8kB

Link

https://ejhm.journals.ekb.eg/article_203742.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=203742

Order

40

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Necrotizing Pneumonia: A Case Report on a Rare Complication of Respiratory Syncytial Virus Pneumonia

Details

Type

Article

Created At

22 Jan 2023