Necrotizing pneumonia caused by Streptococcus pneumoniae in a child with systemic lupus erythematosus.

Necrotizing pneumonia caused by Streptococcus pneumoniae is not an uncommon disease in children. Here we report a case of necrotizing pneumonia caused by Streptococcus pneumoniae in a 13-year-old girl. She was a case of systemic lupus erythematosus (SLE), and has long been treated with corticosteroids and azathioprine. She acquired pneumococcal necrotizing pneumonia later on. After appropriate antimicrobial therapy and surgical intervention, her condition stabilized and she recovered gradually. The present case suggests the need for a comprehensive diagnostic approach in patients with SLE who are undergoing immunosuppressive therapy, in order to screen for the possibility of infections if a new pulmonary pathologic process is present, even if the patient has no symptoms/signs indicating severe pulmonary infections.