• Sriram Ramgopal, Yaron Ivan, Avinash Medsinge, and Richard A Saladino.
• From the *Department of Pediatrics, Children's Hospital of Pittsburgh; †Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine; and ‡Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
• Pediatr Emerg Care. 2017 Feb 1; 33 (2): 112-115.

AbstractNecrotizing pneumonias occur infrequently in children but may be associated with significant morbidity. If not adequately treated, necrotizing pneumonia may lead to complications including bronchopleural fistula, empyema, respiratory failure, and septic shock. Staphylococcus aureus is the most commonly implicated agent, followed by Streptococcus pneumoniae. Antimicrobial treatment is the cornerstone of management, although surgical drainage may be required in some cases. We present the case of a 14-month-old child with fever and cough that persisted despite treatment with typical first-line oral antimicrobial therapy. An initial plain radiograph of the chest demonstrated lobar pneumonia. Ultimately, computed tomography of the chest revealed a cavitary lesion in the left upper lobe of the lung. We review the literature and describe the clinical presentation, diagnosis, microbiological etiology, and management of necrotizing pneumonia in children.

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