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Published: 2022-06-01
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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

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