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Pneumonia With Cavitary Necrosis
Michael R. Aquino, MD, MHSc; Lane F. Donnelly, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Necrotizing pneumonia
              • Pulmonary gangrene
            • Definitions

              • Complication of bacterial pneumonia where dominant focus of necrosis develops in consolidated lung, resulting in variable number(s) of thin-walled cysts

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Ultrasonographic Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Lai SH et al: Value of lung ultrasonography in the diagnosis and outcome prediction of pediatric community-acquired pneumonia with necrotizing change. PLoS One. 10(6):e0130082, 2015
                                      2. LemaƮtre C et al: Necrotizing pneumonia in children: report of 41 cases between 2006 and 2011 in a French tertiary care center. Pediatr Infect Dis J. 32(10):1146-9, 2013
                                      3. Heffner JE et al: Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 137(2):467-79, 2010
                                      4. Calder A et al: Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 39(6):527-37, 2009
                                      5. Kurian J et al: Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. AJR Am J Roentgenol. 193(6):1648-54, 2009
                                      6. Sawicki GS et al: Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J. 31(6):1285-91, 2008
                                      7. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                                      8. Hodina M et al: Imaging of cavitary necrosis in complicated childhood pneumonia. Eur Radiol. 12(2):391-6, 2002
                                      9. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                      10. Juven T et al: Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 19(4):293-8, 2000
                                      11. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                                      12. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                      13. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                                      14. Brunelle F: [Radiologic approach to community-acquired pneumonia] Arch Pediatr. 5 Suppl 1:26s-27s, 1998
                                      15. Donnelly LF et al: Cavitary necrosis complicating pneumonia in children: sequential findings on chest radiography. AJR Am J Roentgenol. 171(1):253-6, 1998
                                      16. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                      17. Donnelly LF et al: CT appearance of parapneumonic effusions in children: findings are not specific for empyema. AJR Am J Roentgenol. 169(1):179-82, 1997
                                      18. Donnelly LF et al: Pneumonia in children: decreased parenchymal contrast enhancement--CT sign of intense illness and impending cavitary necrosis. Radiology. 205(3):817-20, 1997
                                      19. Kerem E et al: Bacteremic necrotizing pneumococcal pneumonia in children. Am J Respir Crit Care Med. 149(1):242-4, 1994
                                      20. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Necrotizing pneumonia
                                                  • Pulmonary gangrene
                                                • Definitions

                                                  • Complication of bacterial pneumonia where dominant focus of necrosis develops in consolidated lung, resulting in variable number(s) of thin-walled cysts

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • Ultrasonographic Findings

                                                        • Nonvascular Interventions

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Lai SH et al: Value of lung ultrasonography in the diagnosis and outcome prediction of pediatric community-acquired pneumonia with necrotizing change. PLoS One. 10(6):e0130082, 2015
                                                                          2. LemaƮtre C et al: Necrotizing pneumonia in children: report of 41 cases between 2006 and 2011 in a French tertiary care center. Pediatr Infect Dis J. 32(10):1146-9, 2013
                                                                          3. Heffner JE et al: Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 137(2):467-79, 2010
                                                                          4. Calder A et al: Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 39(6):527-37, 2009
                                                                          5. Kurian J et al: Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. AJR Am J Roentgenol. 193(6):1648-54, 2009
                                                                          6. Sawicki GS et al: Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J. 31(6):1285-91, 2008
                                                                          7. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                                                                          8. Hodina M et al: Imaging of cavitary necrosis in complicated childhood pneumonia. Eur Radiol. 12(2):391-6, 2002
                                                                          9. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                                                          10. Juven T et al: Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 19(4):293-8, 2000
                                                                          11. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                                                                          12. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                                                          13. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                                                                          14. Brunelle F: [Radiologic approach to community-acquired pneumonia] Arch Pediatr. 5 Suppl 1:26s-27s, 1998
                                                                          15. Donnelly LF et al: Cavitary necrosis complicating pneumonia in children: sequential findings on chest radiography. AJR Am J Roentgenol. 171(1):253-6, 1998
                                                                          16. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                                                          17. Donnelly LF et al: CT appearance of parapneumonic effusions in children: findings are not specific for empyema. AJR Am J Roentgenol. 169(1):179-82, 1997
                                                                          18. Donnelly LF et al: Pneumonia in children: decreased parenchymal contrast enhancement--CT sign of intense illness and impending cavitary necrosis. Radiology. 205(3):817-20, 1997
                                                                          19. Kerem E et al: Bacteremic necrotizing pneumococcal pneumonia in children. Am J Respir Crit Care Med. 149(1):242-4, 1994
                                                                          20. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980