Necrotizing pneumonia in a pediatric patient

Abstract

Pneumonia is the cause of death of approximately 4 million children a year around the world, the vast majority in developingcountries. In the first year of life, the incidence is 15-20 cases/1,000 children/year. From 1 to 5 years it reaches 30-40 cases and,again, it goes down in those older than 5 years to 10-20 cases/1,000 children/year. It is an acute infection of the lower respiratorytract acquired in the community with a duration of less than or equal to 14 days, which causes cough and / or respiratory distressand with radiological evidence of acute pulmonary infiltrate. Streptococcus pneumoniae is the main bacterial agent. e case ofa 2-year-old male preschooler is presented. He begins his current illness with anterior hyaline rhinorrhea, hyperthermia notquantified, dry cough. It is evaluated by a physician and performs paraclinics that report leukocytosis, neutrophilia and reactivethrombocytosis, diagnose a lower respiratory infection and indicate antimicrobial treatment by oral route, which does not showimprovement. Aerwards, respiratory distress is associated, consultation with the health center where they enter and indicate medical treatment during 48 hours without clinical improvement, refer to the University Hospital of Caracas in regular generalconditions. Chest CT shows suggestive images of bilateral necrotizing pneumonia, double antibiotic therapy is indicated for11 days to cover resistant Streptococcus pneumoniae and / or community-acquired methicillin-resistant Staphylococcus Aureus,producer of Panton - Valentine leukocidin. With satisfactory clinical evolution, he withdrew, with oral antibiotic therapy for 21days and control by Pneumopediatrics.