Management of Necrotizing Pneumonia and Pulmonary Gangrene: a Case Series and Review of the Literature

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2014 May 3

PMID 24791253

Citations 30

Authors

Neela Chatha

Dalilah Fortin

Karen J Bosma

Affiliations

Soon will be listed here.

Abstract

Background: Necrotizing pneumonia is an uncommon but severe complication of bacterial pneumonia, associated with high morbidity and mortality. The availability of current data regarding the management of necrotizing pneumonia is limited to case reports and small retrospective observational cohort studies. Consequently, appropriate management for these patients remains unclear.

Objective: To describe five cases and review the available literature to help guide management of necrotizing pneumonia.

Methods: Cases involving five adults with respiratory failure due to necrotizing pneumonia admitted to a tertiary care centre and infected with Streptococcus pneumoniae (n=3), Klebsiella pneumoniae (n=1) and methicillin-resistant Staphylococcus aureus (n=1) were reviewed. All available literature was reviewed and encompassed case reports and retrospective reviews dating from 1975 to the present.

Results: All five patients received aggressive medical management and consultation by thoracic surgery. Three patients underwent surgical procedures to debride necrotic lung parenchyma. Two of the five patients died in hospital.

Conclusions: Necrotizing pneumonia often leads to pulmonary gangrene. Computed tomography of the thorax with contrast is recommended to evaluate the pulmonary vascular supply. Further study is necessary to determine whether surgical intervention, in the absence of pulmonary gangrene, results in better outcomes.

Citing Articles

Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children.

Da Silva P, de Oliveira R, Tamura N, Camargo L, Kubo E World J Pediatr Surg. 2024; 7(4):e000943.

PMID: 39737081 PMC: 11683895. DOI: 10.1136/wjps-2024-000943.

Necrotizing Pneumonia: A Practical Guide for the Clinician.

Kapania E, Cavallazzi R Pathogens. 2024; 13(11).

PMID: 39599537 PMC: 11597800. DOI: 10.3390/pathogens13110984.

community-acquired necrotizing pneumonia, an uncommon presentation of a common pathogen: A case report and literature review.

Mohammad Hosseini A, Farshchi P, Hosseini H, Zarei F Respirol Case Rep. 2024; 12(9):e70015.

PMID: 39224120 PMC: 11368438. DOI: 10.1002/rcr2.70015.

A Case of Necrotizing Pneumonia Complicated by Hydropneumothorax.

Alawad A, Mohamed Abdeen M, Fadul K, Elgassim M, Ahmed S, Elgassim M Cureus. 2024; 16(4):e57775.

PMID: 38716008 PMC: 11076000. DOI: 10.7759/cureus.57775.

Hydropneumothorax as a complication of necrotizing pneumonia.

Papazachariou A, Papadokostaki E, Kypraiou D, Malikides V, Papakitsou I, Filippatos T Germs. 2024; 13(4):332-337.

PMID: 38361549 PMC: 10866169. DOI: 10.18683/germs.2023.1402.

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