Ness-Cochinwala Manette, Totapally Balagangadhar R
Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, FL 33155, USA.
Department of Pediatrics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
Children (Basel). 2025 Sep 17;12(9):1248. doi: 10.3390/children12091248.
Necrotizing pneumonia is a serious complication of pediatric pneumonia, characterized by liquefaction and cavitation of the lung parenchyma. and are the most implicated organisms. has been an increasingly recognized pathogen, especially is Asian and is mainly noted in a higher percentage of patients with complex chronic conditions. Clinical presentation typically includes fever, respiratory distress, and failure to respond to standard antibiotic therapy. These patients are more likely to have pleural involvement in the form of effusion or empyema and a higher need for respiratory support. Diagnosis is typically through a combination of chest radiographs, lung ultrasound, and chest computed tomography. Management is primarily via prolonged intravenous antibiotics that cover the above organisms, though pleural drainage with fibrinolytics is often required. Surgical intervention is often reserved for refractory cases that fail initial fibrinolytic therapy. Prognosis is usually favorable in the short and long term, though early recognition and appropriate management are imperative to reduce the duration of illness and morbidity.
坏死性肺炎是小儿肺炎的一种严重并发症，其特征为肺实质的液化和空洞形成。[具体两种微生物名称未给出]是最常涉及的病原体。[具体一种微生物名称未给出]已日益被公认为病原体，尤其是在亚洲，且在患有复杂慢性病的患者中比例较高。临床表现通常包括发热、呼吸窘迫以及对标准抗生素治疗无反应。这些患者更有可能出现胸腔积液或脓胸形式的胸膜受累，且对呼吸支持的需求更高。诊断通常通过胸部X光片、肺部超声和胸部计算机断层扫描相结合来进行。治疗主要通过长期静脉使用覆盖上述病原体的抗生素，不过通常还需要使用纤维蛋白溶解剂进行胸腔引流。手术干预通常保留给初始纤维蛋白溶解治疗失败的难治性病例。尽管早期识别和适当管理对于缩短病程和降低发病率至关重要，但短期和长期预后通常良好。
