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A case of necrotizing pneumonia leading to respiratory failure and tracheostomy

Azmi N'M, Koeh SK, Zainal TSST, Mazlan MZ

IDCases, 2026

Abstract

Necrotizing pneumonia is a severe lung infection characterized by pulmonary necrosis and high mortality rates of up to 50 %. It is typically caused by toxin-producing pathogens, such as Staphylococcus aureus and Klebsiella pneumoniae. Limited guidelines exist for its management, making its treatment challenging. Case report: We discuss a case of a 58-year-old Malay woman with no significant comorbidity but developed necrotizing pneumonia. The diagnosis was confirmed using computed tomography (CT) of the thorax. Treatment with carbapenem, oxazolidinone and corticosteroid led to significant recovery. Conclusion: To date, no specific anti-inflammatory treatments exist for severe necrotizing pneumonia. Since systemic inflammation and multi-organ failure drive mortality, management focuses on supportive care aimed at maintaining oxygenation and hemodynamic stability to improve outcomes in critically ill patients.

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