Necrotizing pneumococcal pneumonia in children: The role of pulmonary gangrene

Yu Chia Hsieh, Cheng Hsiang Hsiao, Po Nien Tsao, Jann Yuan Wang, Po Ren Hsueh, Bor Luen Chiang, Wen Sen Lee, Li Min Huang

Research output: Contribution to journalArticlepeer-review

64 Citations (Scopus)


Little is known about the mechanism of necrotizing pneumonia caused by Streptococcus pneumoniae in children. Pulmonary gangrene secondary to vascular thrombosis was reported in adults with necrotizing pneumococcal pneumonia. We conducted a retrospective study of 15 children with a diagnosis of necrotizing pneumococcal pneumonia at National Taiwan University Hospital to explore its association with pulmonary gangrene, based on evidence from chest computed tomography, serial chest radiographic patterns, and pathologic results. S. pneumoniae serotype 14 was the prevalent pneumococcal serotype. Overall, 63.6% of isolates were not susceptible to penicillin. One child with pneumonia caused by S. pneumoniae serotype 3 complicated by hemolytic uremic syndrome had a rapidly fatal course. An autopsy in this patient documented lung necrosis and pulmonary gangrene. Radiographic follow-up was performed during the clinical course in 9 patients, and showed no evidence of pulmonary gangrene. Four children had no radiographic follow-up. The relationship between pulmonary gangrene and necrotizing pneumonia was unclear in the remaining one. In conclusion, necrotizing pneumococcal pneumonia may be infrequently associated with pulmonary gangrene in children.

Original languageEnglish
Pages (from-to)623-629
Number of pages7
JournalPediatric Pulmonology
Issue number7
Publication statusPublished - Jul 2006
Externally publishedYes


  • Necrosis
  • Pneumonia
  • Streptococcus pneumoniae
  • Thrombosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine


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