Article Sidebar

PDF (Tiếng Việt)
Published: 2022-06-01
Abstract Views: 794
Views PDF (Tiếng Việt): 759
DOI: https://doi.org/10.52852/tcncyh.v153i5.875
Issue
Vol. 153 No. 5 (2022)
Section
Các bài báo
How to Cite
Phước, N. T. ., & Nga, N. T. Q. . (2022). 28. Necrotizing pneumonia in a neonate: A rare complication of a common disease. Journal of Medical Research, 153(5), 230-238. https://doi.org/10.52852/tcncyh.v153i5.875

28. Necrotizing pneumonia in a neonate: A rare complication of a common disease

Nguyen Trong Phuoc, Nguyen Thi Quynh Nga

Main Article Content

Abstract

Necrotizing pneumonia is a rare and severe complication of pneumonia in children, especially in neonates. This condition is characterized by structural damage and liquefactive necrosis of lung parenchyma, development of multiple small cavities, and is frequently associated with pleural involvement. Currently, no official guideline has been published regarding the management of pediatric necrotizing pneumonia, and the strategy of conservative medical treatment or surgical intervention still depends mainly on the experience of each center. We report a case of a 20-days-old male infant, diagnosed with left-sided necrotizing pneumonia and empyema caused by Methicillin-resistant Staphylococcus aureus (MRSA). The patient underwent video-assisted thorascopic surgery to debride pyogenic material around the lung (decortication), breakdown loculations, and pusremoval, combined with intravenous antibiotic treatment and respiratory support by mechanical ventilation. Vancomycin was prescribed initially based on the results of pleural pus culture and antimicrobial susceptibility test; however, there was no improvement after 12 days of treatment. Instead of switching to surgical intervention to address the necrotic lung parenchyma lesions, we decided to continue with conservative medical treatment by replacing Vancomycin with Linezolid. After 14 days of treatment, the patient's condition improved and was discharged. A checkup carried out after a week came back with normal lab test results and radiologic findings.

Article Details

Keywords

Necrotizing pneumonia, Methicillin resistant staphylococcus aureus, Linezolid, Neonate

References

1. de Benedictis FM, Kerem E, Chang AB, et al. Complicated pneumonia in children. Lancet Lond Engl. 2020;396(10253):786-798. doi: 10.1016/S0140-6736(20)31550-6.
2. Yang B, Zhang W, Gu W, et al. Differences of clinical features and prognosis between Mycoplasma pneumoniae necrotizing pneumonia and non-Mycoplasma pneumoniae necrotizing pneumonia in children. BMC Infect Dis. 2021;21(1):797. doi: 10.1186/s12879-021-06469-x.
3. Kerem E, Bar Ziv Y, Rudenski B, et al. Bacteremic necrotizing pneumococcal pneumonia in children. Am J Respir Crit Care Med. 1994;149(1):242-244. doi: 10.1164/ajrcc m.149.1.8111589.
4. de Benedictis FM, Carloni I. Management of necrotizing pneumonia in children: Time for a patient-oriented approach. Pediatr Pulmonol. 2019;54(9):1351-1353. doi: 10.1002/ppul.24412.
5. Ionescu MD, Popescu NA, Balan G, et al. Evolutionary particularities in a case of severe Pneumonia in children - Case report. Maedica. 2018;13(1):55-60.
6. Nicolaou EV, Bartlett AH. Necrotizing Pneumonia. Pediatr Ann. 2017;46(2):e65-e68. doi: 10.3928/19382359-20170120-02.
7. Masters IB, Isles AF, Grimwood K. Necrotizing pneumonia: an emerging problem in children? Pneumonia Nathan Qld. 2017;9:11. doi: 10.1186/s41479-017-0035-0.
8. Sharma PK, Vinayak N, Aggarwal GK, et al. Severe necrotizing Pneumonia in children: A challenge to intensive care specialist. J Trop Pediatr. 2020;66(6):637-644. doi: 10.1093/tropej/fmaa027.
9. Chen X, Li W, Wang F, et al. Early recognition of necrotizing pneumonia in children based on non-contrast-enhanced computed tomography radiomics signatures. Transl Pediatr. 2021;10(6):1542-1551. doi: 10.21037/tp-20-241.
10. Lai SH, Wong KS, Liao SL. Value of lung ultrasonography in the diagnosis and outcome prediction of Pediatric Community-Acquired Pneumonia with necrotizing change. PloS One. 2015;10(6):e0130082. doi: 10.1371/journal.pone.0130082.
11. Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 2009;39(6):527-537. doi: 10.1007/s00247-008-1133-1.
12. Kato H, Hagihara M, Asai N, et al. Meta-analysis of vancomycin versus linezolid in pneumonia with proven methicillin-resistant Staphylococcus aureus. J Glob Antimicrob Resist. 2021;24:98-105. doi: 10.1016/j.jgar.20 20.12.009.
13. McAdams RM, Mazuchowski E, Ellis MW, et al. Necrotizing staphylococcal pneumonia in a neonate. J Perinatol Off J Calif Perinat Assoc. 2005;25(10):677-679. doi: 10.1038/sj.jp.7211364.
14. Lim WH, Lien R, Huang YC, et al. Community-associated methicillin-resistant Staphylococcus aureus necrotizing pneumonia in a healthy neonate. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi. 2014;47(6):555-557. doi: 10.1016/j.jmii.2012.07.001.
15. Zapata H, Wahba A. Severe necrotizing pneumonia complicated by empyema in a neonate. Respir Med Case Rep. 2020;31:101248. doi: 10.1016/j.rmcr.202 0.101248.