Clinical Characteristics Of35Children With Necrotizing Pneumonia

Objectives To investigate the clinical manifestations, laboratoryfindings and image examination of35children with necrotizingpneumonia, comparing to61children with lobar pneumonia.Methods Retrospective analysis was performed on the clinicaldata of35children hospitalized with necrotizing pneumonia as well as61with lobar pneumonia at the same time. Measurement data conform tonormal distribution or approximately normal distribution was evaluatedby an independent samples t-test, measurement data not conform tonormal distribution was evaluated by non-parametric test, categorical datawas evaluated by Chi square test, in order to find the difference betweenthe two groups.Results (1)There were35cases of necrotizing pneumonia and61cases of lobar pneumonia.(2)No difference was found on age and sexbetween these two groups. The febrile days of necrotizing pneumoniawere more than lobar pneumonia,24.1±12.3days and14.9±5.7days,respectively(P＜0.05). There were more cases of respiratory distress innecrotizing pneumonia group than in lobar pneumonia group,71.4%and23.0%，respectively(P＜0.05).(3)The values of white blood cellcount(WBC), neutrophil ratio(NE%), C-reactive protein (CRP)and serumlactic dehydrogenas(LDH) in necrotizing pneumonia group were (15.44± 6.87)×109/L,72.3%±10.6%,160.0(IQR64.0~187.0) mg/L,(584±310)U/L, higher than those in lobar pneumonia group,(9.65±4.29)×109/L,62.4%±11.8%,45.3(IQR26.8~98.8) mg/L,363±163U/L, respectively(P＜0.05). The values of serum albumin (ALB)(g/L)in necrotizingpneumonia group was lower than that in lobar pneumonia group,(29.8±3.7vs.33.7±4.3，P＜0.05).(4)The ratio of cases consolidated in2andmore lobes, complicated with middle or large amount of pleural effusionsand with bronchoalveolar lavage fluid like rice soup in necrotizingpneumonia group were higher than those in lobar pneumonia group,94.3%vs.47.5%，37.1%vs.8.2%，25.7%vs.0, respectively (P＜0.05).Conclusions If a lobar pneumonia patient presents with fever morethan20days, respiratory distress, and WBC≥15×109/L，NE%≥70%，CRP≥100mg/L，LDH≥550U/L，ALB≤30g/L， and consolidation in2and more lobes, middle or large amount of pleural effusions,bronchoalveolar lavage fluid like rice soup, necrotizing pneumoniashould be highly considered.