{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:52:14Z","timestamp":1790905934591,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,10]],"date-time":"2024-11-10T00:00:00Z","timestamp":1731196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>While rare, necrotizing pneumonia is a severe and potentially life-threatening manifestation of lung parenchyma infection. Initially documented in the 1940s, it was a significant contributor to mortality rates in both adults and children, with figures reaching up to 45%. Despite being a disease described in the literature for decades, data on the management of necrotizing pneumonia remain limited. Most available information comes from retrospective observational cohort studies. This article aims to provide a comprehensive summary of the existing literature on the subject.<\/jats:p>","DOI":"10.3390\/pathogens13110984","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T08:12:39Z","timestamp":1731399159000},"page":"984","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Necrotizing Pneumonia: A Practical Guide for the Clinician"],"prefix":"10.3390","volume":"13","author":[{"given":"Esha Madhu","family":"Kapania","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Disorders, Department of Medicine, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Cavallazzi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Disorders, Department of Medicine, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,10]]},"reference":[{"key":"ref_1","first-page":"240","article-title":"Necrotising pneumonia in children","volume":"15","author":"Spencer","year":"2014","journal-title":"Paediatr. Respir. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3860","DOI":"10.21037\/jtd-22-1590","article-title":"Survival with optimal medical management in a cohort of severe necrotizing bacterial lung infections","volume":"15","author":"Larose","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"ref_3","first-page":"239","article-title":"Management of necrotizing pneumonia and pulmonary gangrene: A case series and review of the literature","volume":"21","author":"Chatha","year":"2014","journal-title":"Can. Respir. J. J. Can. Thorac. Soc."},{"key":"ref_4","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 Leukocidin","volume":"45","author":"Gillet","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1097\/MCP.0000000000000571","article-title":"Necrotizing pneumonia (aetiology, clinical features and management)","volume":"25","author":"Krutikov","year":"2019","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1097\/00007611-199810000-00012","article-title":"Pulmonary gangrene: Radiological and pathologic correlation","volume":"91","author":"Curry","year":"1998","journal-title":"South. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.rmed.2013.10.012","article-title":"Clinical characteristics of septic pulmonary embolism in adults: A systematic review","volume":"108","author":"Ye","year":"2014","journal-title":"Respir. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S0022-5223(19)41311-1","article-title":"Clinical spectrum of septic pulmonary embolism and infarction","volume":"75","author":"MacMillan","year":"1978","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/cid\/cir749","article-title":"The Incidence of Necrotizing Changes in Adults With Pneumococcal Pneumonia","volume":"54","author":"Pande","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1111\/resp.12943","article-title":"Clinical relevance of necrotizing change in patients with community-acquired pneumonia","volume":"22","author":"Seo","year":"2017","journal-title":"Respirology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/MCP.0b013e3283521022","article-title":"Necrotizing pneumonia: A rare complication of pneumonia requiring special consideration","volume":"18","author":"Tsai","year":"2012","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3777","DOI":"10.2147\/IDR.S419294","article-title":"Clinical Characteristics of Necrotizing Pneumonia Caused by Different Pathogens","volume":"16","author":"Luo","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_13","first-page":"1717492","article-title":"Necrotizing Pseudomonas aeruginosa Community-Acquired Pneumonia: A Case Report and Review of the Literature","volume":"2017","author":"Maharaj","year":"2017","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1172\/JCI200420773","article-title":"TLR2 is mobilized into an apical lipid raft receptor complex to signal infection in airway epithelial cells","volume":"113","author":"Soong","year":"2004","journal-title":"J. Clin. Investig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1600-065X.2007.00550.x","article-title":"How human neutrophils kill and degrade microbes: An integrated view","volume":"219","author":"Nauseef","year":"2007","journal-title":"Immunol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1152\/physrev.00032.2017","article-title":"Integrative Physiology of Pneumonia","volume":"98","author":"Quinton","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1159\/000319557","article-title":"Factors Associated with the Outcome of Life-Threatening Necrotizing Pneumonia due to Community-Acquired Staphylococcus aureus in Adult and Adolescent Patients","volume":"81","author":"Li","year":"2010","journal-title":"Respiration"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1586\/14787210.2013.827891","article-title":"Pathogenesis of Staphylococcus aureus necrotizing pneumonia: The role of PVL and an influenza coinfection","volume":"11","author":"Niemann","year":"2013","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1126\/science.1137165","article-title":"Staphylococcus aureus Panton-Valentine Leukocidin Causes Necrotizing Pneumonia","volume":"315","author":"Couzon","year":"2007","journal-title":"Science"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1139\/W10-002","article-title":"Effect of recombinant Panton-Valentine leukocidin in vitro on apoptosis and cytokine production of human alveolar macrophages","volume":"56","author":"Wu","year":"2010","journal-title":"Can. J. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/infdis\/171.3.607","article-title":"Effects of Staphylococcus aureus leukocidins on inflammatory mediator release from human granulocytes","volume":"171","year":"1995","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2732","DOI":"10.1378\/chest.128.4.2732","article-title":"Pleuropulmonary complications of Panton-Valentine leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus: Importance of treatment with antimicrobials inhibiting exotoxin production","volume":"128","author":"Micek","year":"2005","journal-title":"Chest"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1086\/586747","article-title":"Pneumococcal Necrotizing Pneumonia in Utah: Does Serotype Matter?","volume":"46","author":"Bender","year":"2008","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1378\/chest.104.5.1610","article-title":"Severe Pneumococcal Pneumonia Complicated by Massive Pulmonary Gangrene","volume":"104","author":"Hammond","year":"1993","journal-title":"Chest"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1159\/000327684","article-title":"Surgical Treatment of 26 Patients with Necrotizing Pneumonia","volume":"47","author":"Tsai","year":"2011","journal-title":"Eur. Surg. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1155\/2006\/760390","article-title":"Surgical management of acute necrotizing lung infections","volume":"13","author":"Reimel","year":"2006","journal-title":"Can. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2217\/17460913.3.4.397","article-title":"Improving therapeutic strategies for secondary bacterial pneumonia following influenza","volume":"3","author":"McCullers","year":"2008","journal-title":"Future Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1016\/j.ejim.2013.08.149","article-title":"Lung abscess and necrotizing pneumonia: A hospital\u2019s experience","volume":"24","author":"Sousa","year":"2013","journal-title":"Eur. J. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/S1473-3099(16)30267-5","article-title":"GLIMP investigators Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): An international, observational cohort study","volume":"16","author":"Aliberti","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/1060028020935106","article-title":"Risk Factor Evaluation for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa in Community-Acquired Pneumonia","volume":"55","author":"Lewis","year":"2021","journal-title":"Ann. Pharmacother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.idc.2012.11.016","article-title":"How Important Are Anaerobic Bacteria in Aspiration Pneumonia","volume":"27","author":"Bartlett","year":"2013","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e061023","DOI":"10.1136\/bmjopen-2022-061023","article-title":"Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: A systematic review and duration-effect meta-analysis","volume":"13","author":"Furukawa","year":"2023","journal-title":"BMJ Open"},{"key":"ref_35","first-page":"298","article-title":"Long-term outcomes of necrotizing pneumonia","volume":"95","author":"Osona","year":"2021","journal-title":"An. Pediatr\u00eda Engl. Ed."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.amjms.2019.04.005","article-title":"Procalcitonin-Guided Antibiotic Discontinuation Might Shorten the Duration of Antibiotic Treatment Without Increasing Pneumonia Recurrence","volume":"358","author":"Akagi","year":"2019","journal-title":"Am. J. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.ccm.2018.07.004","article-title":"The Role of Biomarkers in the Diagnosis and Management of Pneumonia","volume":"39","author":"Sungurlu","year":"2018","journal-title":"Clin. Chest Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"357ra124","DOI":"10.1126\/scitranslmed.aag1153","article-title":"IVIG-mediated protection against necrotizing pneumonia caused by MRSA","volume":"8","author":"Diep","year":"2016","journal-title":"Sci. Transl. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1056\/NEJMoa2215145","article-title":"Hydrocortisone in Severe Community-Acquired Pneumonia","volume":"388","author":"Dequin","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00134-022-06684-3","article-title":"Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia","volume":"48","author":"Meduri","year":"2022","journal-title":"Intensive Care Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1016\/j.jtcvs.2017.01.030","article-title":"The American Association for Thoracic Surgery consensus guidelines for the management of empyema","volume":"153","author":"Shen","year":"2017","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/00045413-200301000-00004","article-title":"Surgical Management of Necrotizing Pneumonia","volume":"10","author":"Harrington","year":"2003","journal-title":"Clin. Pulm. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40560-020-00441-8","article-title":"Management of life-threatening hemoptysis","volume":"8","author":"Kathuria","year":"2020","journal-title":"J. Intensive Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"197","DOI":"10.34197\/ats-scholar.2022-0008PS","article-title":"ABCDE Approach for Massive Hemoptysis: A Novel Cognitive Aid","volume":"3","author":"New","year":"2022","journal-title":"ATS Sch."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/984\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:29:37Z","timestamp":1760113777000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,10]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["pathogens13110984"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13110984","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,10]]}}}