Retrospective analysis of necrotizing pneumonia in children between 2015–2019


Authors: O. Marek 1;  J. Tůma 1;  J. Papež 2;  J. Turek 1;  A. Seehofnerová 3;  L. Plánka 1
Authors‘ workplace: Klinika dětské chirurgie, ortopedie a traumatologie Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity, Brno 1;  Pediatrická klinika Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity, Brno 2;  Klinika dětské radiologie Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity, Brno 3
Published in: Rozhl. Chir., 2022, roč. 101, č. 2, s. 72-78.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2022.101.2.72–78

Overview

Introduction: An increased incidence rate of cases of complicated pneumonia, reaching up to the stage of necrotizing pneumonia was observed at University Hospital Brno in the past period. The aim of this study was to perform a single-center retrospective analysis of patients with acquired inflammatory lung disease requiring surgical treatment, comprising a long-term follow-up group.

Methods: Patients hospitalized for community-acquired pneumonia and surgically treated in the years 2015–2019 were analyzed. The rates of necessary chest drainages, decortications and lung resections in relation to the whole group and individual years were monitored. Clinical and X-ray examinations were performed one year after hospitalization and the prognosis was determined for individual types of required treatments. The age, gender and etiological agents were also monitored.

Results: A total of 688 patients were included in the study with the incidence rising until 2018 and decreasing slightly in 2019. A statistically significantly higher number of community-acquired pneumonias and complications was recorded between 2017 and 2018 (p<0.05). Of the total number of patients, 46 (6.7%) required surgical treatment, which was started with chest drainage in all cases. A total of 17 patients required later decortication and finally, 7 patients required lung resection. X-ray changes were seen only in one patient with adequately reduced breath sounds on auscultation, although without a clinical correlate or subjective impression, after one year of follow-up.

Conclusion: The number of patients with complicated bronchopneumonia who require hospitalization has been growing during the last years. Decortication or lung resection resulted in a rapid improvement of the condition in all cases and did not leave any clinical or subjective difficulties in the long-term follow-up. Surgical treatment has an irreplaceable role in the treatment of necrotizing pneumonia.

Keywords:

Streptococcus pneumoniae – child – necrotizing pneumonia – partial pneumonectomy


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