Complicated community acquired pneumonia in childhood: Different types, clinical course, and outcome

Erlichman, Ira; Breuer, Oded; Shoseyov, David; Cohen‐Cymberknoh, Malena; Koplewitz, Benjamin Z.; Averbuch, Diana; Erlichman, Matityahu; Picard, Elie; Kerem, Eitan

doi:10.1002/ppul.23523

Cited by 50 publications

(78 citation statements)

References 40 publications

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“…In agreement with previous studies, all the children presented in this study were pre‐school children (Table ). Other than the young age, we found no other risk factors for the development of giant lung cysts.…”

Section: Discussionsupporting

confidence: 92%

“…Despite growing numbers of patients with complicated pneumonia, including NP, there is no current consensus regarding how to treat these children due to the lack of large controlled studies. A recent opinion driven article, suggested that children who were classified as suffering from complicated pneumatocele should be treated by image‐guided catheter drainage.…”

Section: Discussionmentioning

confidence: 99%

“…The most common pathogen causing NP is Streptococcus pneumonia followed by Staphylococcus aureus and Streptococcus pyogenes . Since our first report on NP in 1994 several publications have indicated an increased incidence of complicated pneumonia in general and NP in particular …”

Section: Introductionmentioning

confidence: 99%

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Giant lung cysts following necrotizing pneumonia: Resolution with conservative treatment

Gross

Gordon

Cohen‐Cymberknoh³

et al. 2019

Pediatric Pulmonology

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Rationale Necrotizing pneumonia is characterized by destruction and liquefaction of the lung tissue and loss of the normal pulmonary parenchymal architecture. During the course of resolution areas of hyperlucency are formed, sometimes with the development of giant lung cysts that can be a field with fluid resembling lung abscess. There is no consensus on the management of these abnormalities. Objective To assess the prevalence of giant lung cysts as a complication of necrotizing pneumonia and to report our experience with conservative treatment that achieved complete resolution. Methods Medical chart reviews of all children aged 0 to 18 years hospitalized with necrotizing pneumonia in a single tertiary center from 2015 to 2017, demographic data, and clinical course during and after hospitalization as well as serial chest imaging were collected. Results During the study period, 761 children were diagnosed with community‐acquired pneumonia, 16 of 761 (2.3%) had necrotizing pneumonia and 6 of 16 (37.5%) with necrotizing pneumonia complicated by a giant lung cyst or lung abscess. All were closely observed and showed complete clinical and radiographic resolution with antibiotic treatment. Conclusions Treatment of giant lung cyst formation following necrotizing pneumonia by a conservative approach with prolonged antibiotics results in complete recovery with no need for invasive procedures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Giant lung cysts following necrotizing pneumonia: Resolution with conservative treatment

Gross

Gordon

Cohen‐Cymberknoh³

et al. 2019

Pediatric Pulmonology

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“…In an interesting case‐control study, it was reported that the angiotensin converting enzyme polymorphism rs4340 was associated with increased risk for CAP in Egyptian children . Erlichman et al in Israel reported a retrospective analysis of 144 hospitalized patients over a 10‐year period, with CAP complicated by necrotizing pneumonia, empyema, or parapneumonic effusion . Necrotizing pneumonia tended to be more severe and require longer hospital admission.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Pulmonology year in review 2017: Part 3

Ren

Muston

Yılmaz

et al. 2018

Pediatric Pulmonology

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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“…Necrotizing pneumonia (NP) is a fairly rare but increasing lung infection mostly associated with pleural empyema (94% -97%) [1]- [6].…”

Section: Introductionmentioning

confidence: 99%

Should Empyema with or without Necrotizing Pneumonia in Children Be Managed Differently?

Stelle¹,

Mornand²,

Bajwa³

et al. 2017

Health

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Background: Necrotizing pneumonia (NP) is an increasing lung infection mostly associated with pleural empyema. Objectives: We aimed to compare children with empyema with and without concomitant NP, in terms of risk factors, management and outcome. Methods: We retrospectively included children hospitalized between 2005-2014 with empyema to whom a computed tomography was performed. We recorded patient characteristics, clinical, biological (blood and pleural fluid) and radiological findings, medical and surgical treatments, and clinical, radiological and functional follow-up. Results: 35 children with empyema were included, including 25 with a concomitant NP. Patients with or without NP were undistinguishable, in terms of characteristics, symptoms at admission or detected pathogens. Pleural leucocytes were significantly higher in the empyema group (p = 0.0002) as pleural LDH (p = 0.002), and pleural/blood LDH ratio (p = 0.0005). Medical and surgical managements were similar between both groups. Complications occurred in 1/10 children with empyema alone (pneumatocele) and 5/25 with concomitant NP (bronchopleural fistula (n = 3), lobectomy, pneumothorax). The hospital length of stay and delay for chest X-ray normalization were similar in both groups. Conclusion: Except for minor biological parameters, the presence of concomitant NP in case of empyema does not change the presentation, clinical features, management and outcome, suggesting that the presence of additional NP to empyema should not be managed differently. Therefore, in case of empyema with suspected concomitant NP, chest CT should probably be restricted to abnormal worsening or when mandatory for surgical treatment.

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Complicated community acquired pneumonia in childhood: Different types, clinical course, and outcome

Cited by 50 publications

References 40 publications

Giant lung cysts following necrotizing pneumonia: Resolution with conservative treatment

Giant lung cysts following necrotizing pneumonia: Resolution with conservative treatment

Pediatric Pulmonology year in review 2017: Part 3

Should Empyema with or without Necrotizing Pneumonia in Children Be Managed Differently?

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