%0 Journal Article
%T Necrotizing pneumonia in children: Report of 25 cases between 2008 and 2018 at a French tertiary care center.
%A Cathalau M
%A Michelet M
%A Rancé A
%A Martin-Blondel G
%A Abbo O
%A Dubois D
%A Labouret G
%A Grouteau E
%A Claudet I
%A Ricco L
%A Roditis L
%A Mansuy JM
%A Simon S
%A Bréhin C
%J Arch Pediatr
%V 31
%N 3
%D 2024 Apr 13
%M 38485569
%F 1.82
%R 10.1016/j.arcped.2023.12.004
%X <B>BACKGROUND: </B>Necrotizing pneumonia (NP) is a serious and rare disease in children. Pediatric data on NP are limited and the impact of the 13-valent pneumococcal conjugate vaccine has been very poorly evaluated.<BR><B>METHODS: </B>We conducted a retrospective study at Toulouse University Hospital between 2008 and 2018. Children who presented with thin-walled cavities in the areas of parenchymal consolidation on imaging were included in the study.<BR><B>RESULTS: </B>The incidence of NP did not decrease during this period. Bacterial identification occurred in 56% of cases (14/25) and included six cases of Streptococcus pneumoniae, five of Staphylococcus aureus, two of Streptococcus pyogenes, and one of Streptococcus viridans. Streptococcus pneumoniae NP are more frequently associated with empyema/parapneumonic effusion compared to S. aureus NP (p = 0.02). Patients with S. pyogenes NP more often required volume expansion than did S. pneumoniae cases (p = 0.03). When comparing children born before and after implementation of the 13-valent pneumococcal conjugate vaccine, we identified a relative modification of the bacterial epidemiology, with an increase in the proportion of S. pyogenes NP and S. aureus NP and a decrease in the proportion of NP caused by S. pneumoniae.<BR><B>CONCLUSIONS: </B>Future studies are needed to assess the epidemiology of NP in children. Continued surveillance of identified pneumococcal serotypes is essential to document epidemiological changes in the coming years.