Lung isolation in a child with unilateral necrotizing Clostridium perfringens pneumonia

Life-threatening complications of streptococcal sepsis: a PICU contemporary series

Background

Life-threatening streptococcal sepsis nowadays represents an uncommon event in previously healthy infants and children. Critically ill patients suffering from severe streptococcal sepsis complications may present with pre-antibiotic era clinical pictures and require a timely clinical approach to achieve restitutio ad integrum.

Results

We report a series of four patient groups affected by an uncommon life-threatening streptococcal sepsis, each of them exhibiting some distinct features. Streptococcus Agalactiae sepsis was associated with cerebral thrombotic/ischaemic lesions, whereas severe cardiogenic shock was prominent in the Streptococcus Viridans group; Streptococcus Faecalis and β-hemolytic group A Streptococcus patients mostly reported lung complications.

Conclusions

Previous antibiotic treatments should not delay aggressive treatment in the intensive care setting. Early diagnostic suspicion, as well as appropriate and aggressive treatment provided within an intensive care setting are crucial for the clinical outcome.

[Necrotizing pneumonia in children: apropos of 4 cases]

OBJECTIVES

To describe the necrotizing pneumonia in children, a severe affection which prevalence seems to increase; to review literature.

PATIENTS AND METHODS

We report 4 cases of necrotizing pneumonia: symptoms, agents, diagnostic tools, treatment and long term evolution.

RESULTS

In 2 cases, pneumatoceles could be seen at chest X-ray. Two patients presented a deficiency of anti-pneumococcal antibodies. Three needed insertion of a pleural chest tube of whom 1 had a resection of a small piece of necrotic lung. Duration of hospitalisation is longer than in uncomplicated pneumonias.

CONCLUSION

Necrotizing pneumonia is a severe affection. Diagnosis has to be made by lung CT. Long term evolution is excellent in pediatric population with serious management at hospital.