Necrotizing Pneumonia Complicating Community-acquired Pneumonia: A Mini-series and Narrative Review
Abstract
Review ARticlesecondary infection, bacterial pneumonia, fungal pneumonia, and tuberculosis (TB).CECT thorax revealed dense consolidation involving the right middle and lower lobes, with scattered nodules in the right middle, left upper, and left lower lobes, with no mediastinal lymphadenopathy (Fig. 1A).Sputum smear for acidfast bacilli (AFB) and sputum pyogenic culture were sterile, and tuberculin test was nonreactive (5 × 5 mm).Throat and nasal swab tests for SARS-CoV-2 and influenza were negative.Serology for HIV, hepatitis B and C were negative.HbA1c was 5.9%.Urine and blood cultures were sterile.Ultrasonography (USG) of the whole abdomen was normal.The patient was initiated on an intravenous (IV) antibiotic regimen consisting of ceftriaxone and gentamicin. IntroductIonNecrotizing pneumonia (NP) is an unusual yet life-threatening evolution of community-acquired pneumonia (CAP), in which areas of pulmonary parenchyma undergo liquefaction and cavitate.1 The diagnosis typically depends on radiology, classically demonstrating consolidation interspersed with multiple low-attenuation foci of necrosis.2 NP usually manifests as lifethreatening hemoptysis, sepsis, and rapidly progressive acute respiratory failure.Absence of blood supply impedes the delivery of antibiotics, resulting in sloughing and pulmonary gangrene.Necrotizing pneumonia patients are challenging to treat since there are no specific guidelines that define when to switch from medical to surgical treatment.3…
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