Pneumonias necrosantes em crianças previamente saudáveis

摘要: Background: Necrotizing pneumonia used to be rare in the postantibiotic era. Its incidence appears rising our hospital although there is no clear explanation for that. Patients and Methods: Retrospective analysis of clinical presentation evolution necrotizing previously healthy children admitted at during two years. Results: Among 392 admissions study period, 15 patients (3,4–2, 4 years; 9 boys) had evidence lung necrosis on thoracic computed tomography. Despite appropriate antibiotic therapy, fever persisted 13–7 days. Ten deve loped pneumatoceles three abscesses. Twelve parapneumonic pleural effusions (4 empyemas), nine whom need closed chest drainage. An agent was isolated from fluid or blood culture 3 (2 S. aureus 1 Enterobacter cloacae); further, bacteria were seen Gram-stained fluid. Two an immunodefficiency state unknown (IgA deficiency hiper-IgE syndrome). Thoracotomy performed patients: 2 debridement, 6 decortication, ressection a giant pneumatocele, abscess drainage lobectomies. The mean length stay 30–11 days deaths. During follow-up period (18–9 months) required surgery recurrent infection fibrothorax. In remaining, asymptomatic children, have ticknening, residual pneumatocele bronchiectasis. Conclusions: results this do not explain recent increase suppurative complications community acquired-pneumonia children. low rate infectious isolation probably related with frequent previous use. Although final outcome generally good, course very prolonged frequently needed. order clarify reason kind prospective multicenter warranted. REV PORT PNEUMOL 2002; VIII (1):