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Influenza virus infection complicated by bacterial necrotising pneumonia: two case reports
Augusta Aragão Arruda1, Joana Pacheco Fortuna1, Ana Teresa Raposo1
1Department of Paediatrics, Hospital Divino Espirito Santo, de Ponta Delgada EPER , Açores, Portugal.
Insights
Necrotising pneumonia (NP) is a severe lung complication. This study presents two boys with influenza-associated NP caused by Streptococcus pneumoniae, highlighting their intensive care needs and full recovery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Necrotising pneumonia (NP) is a severe complication of community-acquired pneumonia.
- Influenza infection can predispose children to severe NP.
Observation:
- Two pediatric cases of severe NP caused by Streptococcus pneumoniae following influenza infection are presented.
- Both patients required intensive care and invasive respiratory support.
- One patient experienced significant systemic complications including anemia and edema.
Findings:
- Streptococcus pneumoniae was identified as the causative agent in both cases of NP.
- Influenza virus acted as a potential precipitating factor for NP development.
- Despite extensive pleural involvement, only one patient required thoracic surgery.
Implications:
- Early consideration of NP is crucial for children with persistent pneumonia despite antibiotic treatment, especially with pleural disease.
- Prompt diagnosis and management are vital for favorable outcomes in pediatric NP.
- Understanding the role of influenza as a trigger for bacterial pneumonia is important for prevention and treatment strategies.
Abstract:
Necrotising pneumonia (NP) is a potentially severe complication of community-acquired pneumonia characterised by necrosis of consolidated lung tissue. A 7-year-old boy and a 6-year-old boy are presented, both of whom had a complicated influenza infection which evolved into severe NP caused by Streptococcus pneumoniae. Both needed intensive care for invasive respiratory support. Despite extensive pleural involvement in both cases, only one required thoracic surgery. Case 1 also developed anaemia, hyponatraemia and hypo-albuminaemia, resulting in generalised oedema. Despite the severe morbidity, both boys made a full recovery. The diagnosis of NP should always be considered in a child with pneumonia who remains unwell despite 72 hours of appropriate antibiotics, particularly if there is evidence of pleural disease. Although S. pneumoniae is the main agent for NP, the influenza virus may be a precipitating factor.
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