{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:35:12Z","timestamp":1790044512053,"version":"4.0.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,5,31]],"date-time":"2020-05-31T00:00:00Z","timestamp":1590883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Necrotizing pneumonia (NP) is recently recognized as a complication of pneumonia. The data on NP are scant from developing world and we aimed to describe the characteristic features of NP in our children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>Single center retrospective cohort analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patient selection<\/jats:title>\n                  <jats:p>Institutional database of children treated for pneumonia between September 2014 and May 2018 was searched to identify children with NP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The demographic characteristics, laboratory results, and clinical information were recorded for patients selected as NP and analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 10 patients (3.7%) of NP were identified out of 272 patients with pneumonia. Median age was 3 years (range: 3\u2009months to 12years). All cases had severe respiratory distress and 70% required mechanical ventilation and inotropic support. The causative pathogens were identified in 6\/10 children (60%) with Staphylococcus aureus being most common (4\/10). Pleural effusion and pneumothorax were seen in six cases. Four cases had bilateral pleural effusion and three had bilateral pneumothorax. Intercostal drainage (ICD) was placed in 70% and bilateral ICD was placed in 40% cases. Bronchopleural fistula (BPF) developed in two cases and one had bilateral BPF. Median [inter quartile range] ICD days and hospital stay were 9 (6\u201314) and 13.5 (7.5\u201318.5) days, respectively. Mean (\u00b1SD) total antibiotic (in hospital plus outpatient) days were 28.8\u2009\u00b1\u20099.6\u2009days. Four cases had airway hemorrhage and in three cases this was massive and fatal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>NP is a relatively rare but severe complication of pneumonia distinct from pediatric acute respiratory distress, pleural effusion and empyema. Airway hemorrhage is the most fatal complication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/tropej\/fmaa027","type":"journal-article","created":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T11:10:20Z","timestamp":1586603420000},"page":"637-644","source":"Crossref","is-referenced-by-count":11,"title":["Severe Necrotizing Pneumonia in Children: A Challenge to Intensive Care Specialist"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-5797","authenticated-orcid":false,"given":"Pradeep Kumar","family":"Sharma","sequence":"first","affiliation":[{"name":"Pediatric Critical Care and Pulmonology Unit, Department of Pediatrics, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Vinayak","sequence":"additional","affiliation":[{"name":"Pediatric Critical Care and Pulmonology Unit, Department of Pediatrics, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girraj K","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R D","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep Kumar","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand Singh","family":"Kushwaha","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Sri Balaji Action Medical Institute, New Delhi 110086, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,31]]},"reference":[{"key":"2020113008565988100_fmaa027-B1","year":"2019"},{"key":"2020113008565988100_fmaa027-B2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1164\/ajrccm.149.1.8111589","article-title":"Bacteremic necrotizing pneumococcal pneumonia in children","volume":"149","author":"Kerem","year":"1994","journal-title":"Am J Respir Crit Care Med"},{"key":"2020113008565988100_fmaa027-B3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s41479-017-0035-0","article-title":"Necrotizing pneumonia: an emerging problem in children?","volume":"9","author":"Masters","year":"2017","journal-title":"Pneumonia"},{"key":"2020113008565988100_fmaa027-B4","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s00431-011-1651-y","article-title":"Panton-valentine leucocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature","volume":"171","author":"Schwartz","year":"2012","journal-title":"Eur J Pediatr"},{"key":"2020113008565988100_fmaa027-B5","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1183\/09031936.00099807","article-title":"Necrotising pneumonia is an increasingly detected complication of pneumonia in children","volume":"31","author":"Sawicki","year":"2008","journal-title":"Eur Respir J"},{"key":"2020113008565988100_fmaa027-B6","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1097\/INF.0b013e31829be1bb","article-title":"Necrotizing pneumonia in children. Report of 41 cases between 2006 and 2011 in a French tertiary care center","volume":"32","author":"Lemaitre","year":"2013","journal-title":"Pediatr Infect Dis J"},{"key":"2020113008565988100_fmaa027-B7","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1086\/381974","article-title":"Clinical manifestations and molecular epidemiology of necrotizing pneumonia and empyema caused by Streptococcus pneumoniae in children in Taiwan","volume":"38","author":"Hsieh","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2020113008565988100_fmaa027-B8","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1086\/519263","article-title":"Factors predicting mortality in necrotizing community-acquired pneumonia caused by Staphylococcus aureus containing Panton-valentine leucocidin","volume":"45","author":"Gillet","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2020113008565988100_fmaa027-B9","first-page":"164","article-title":"Severe Staphylococcus aureus infection in three pediatric intensive care units. Analysis of cases of necrotizing pneumonia","volume":"112","author":"Taffarel","year":"2014","journal-title":"Arch Argent Pediatr"},{"key":"2020113008565988100_fmaa027-B10","first-page":"670","volume-title":"Robbins & Cotran Pathologic Basis of Disease","author":"Husain","year":"2015","edition":"9th edn."}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/66\/6\/637\/34597624\/fmaa027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/66\/6\/637\/34597624\/fmaa027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T13:57:51Z","timestamp":1606744671000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/66\/6\/637\/5849168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,31]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,5,31]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmaa027","relation":{},"ISSN":["1465-3664"],"issn-type":[{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,5,31]]}}}