Pediatric Necrotizing Pneumonia: Case report and Overview of Conservative Treatment

Necrotizing pneumonia in children is a rare and severe complication of bacterial community-acquired pneumonia. Main characteristics are a loss of normal lung parenchyma and formations of multiple thin-walled cavities filled with air or fluid. Treatment with antibiotics broad spectrum and pleural drainage is often enough, and children get fully recovered in 5-6 months after diagnosis. The child was admitted to our clinic with 38.5 C and irritating cough, misdiagnosed and treated before as pneumonia. On the x-ray of the chest was left homogenous shade. Abdominal ultrasound showed locally pleural effusion. CT scan showed multilocular denser fluid encapsulated in left hemithorax and acted compressively to the mediastinum and suppresses it to the right. Laboratory findings indicate elevated erythrocyte sedation, leukocytopenia, thrombocytopenia, elevated serum amylase, lipase, amylase in thoracic drainage content, amylase in urine, also reduced values of haemoglobin, MCV, MCHC, urea, creatinine. We gave to patient meropenem and vancomycin. And patient after 24 hours became afebrile with 90 ml haemorrhagic content in a pleural drain. CRP was declining. The radiograph of the chest shows a re-expansion of the lungs with an elevated left diaphragm. Necrotizing pneumonia can be successfully treated with antibiotics and pleural drainage without major surgical procedures.