Clinical characteristics of necrotizing pneumococcal pneumonia in childhood / 中国小儿急救医学

ABSTRACT

Objective To summarize the clinical characteristics of necrotizing pneumococcal pneu-monia in childhood,so as to estimate the prognosis and guide the therapy. Methods We retrospectively col-lected and analyzed the data of 15 necrotizing pneumococcal pneumonia cases hospitalized in the pediatric de-partment of Shengjing Hospital from January 2008 to April 2011. The clinical features and treatment outcomes were analyzed,which included sex, age, maximum body temperature, hospital stay, duration of fever, white blood cell count and C-reactive protein level. Fifteen strains of the clinical isolated streptococcus were ana-lyzed antimicrobial susceptibility test with the disk diffusion procedure,and eleven strains of them were ana-lyzed by with minimal inhibitory concentrations. Results All of 15 cases had fever and pleural effusion,1 case with extrapulmonary manifestations. In chest X-ray and CT scanning,the lesion location were on the left in 7 cases,on the right in 7 cases,bilateral in 1 case. All patients had increased white blood cell count and C-reactive protein. Fifteen strains of streptococcus pneumoniae were collected from clinic samples,which had high sensitivity to vancomycin,linezolid,rifampicin,levofloxacin,no resistant strains appeared. We observed that the resistant rates of streptococcus pneumoniae to penicillin was 7/15,and to erythromycin and clindamy-cin were 11/11 and 10/11. The average length of stay in hospital was 39 d and no death occurred during the hospitalization. Conclusion The treatment of necrotizing pneumococcal pneumonia in childhood usually takes a longer time,and patients always have obvious symptoms. The drug-resisting of streptococcus pneu-moniae are serious,and children with necrotizing pneumococcal pneumonia are easily complicated by pleural effusion. But through active treatment,the prognosis is good.