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Volume 15, Number 10—October 2009

Letter

Severe Necrotizing Pneumonia in Children, Houston, Texas, USA

Anupama S. KalaskarComments to Author , Gloria P. Heresi, Audrey Wanger, James R. Murphy, and Susan H. Wootton
Author affiliations: University of Texas Health Science Center at Houston, Houston, Texas, USA

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Table

Characteristics of patients in study of severe necrotizing pneumonia in children, Houston, Texas, USA, 2007–2008*

Characteristic Patient
1 2 3 4
Age, y 4.1 2.8 3.4 3.7
Race Black White Black Black
Sex M M F F
Completed PCV-7 series Yes Yes Yes Yes
Co-illnesses
Asthma
None
None
None
Clinical signs
Date 2007 Nov 2007 Nov 2007 Dec 2008 Feb
Temperature, °C 37.6 38.9 37.9 38.7
Pulse, beats/min 154 160 162 188
Respiratory rate, breaths/min 70 60 40 42
Blood pressure, mm Hg 95/53 122/84 110/78 106/69
Oxygen saturation on room air, %
85
90
100
86
Symptoms/signs (hospital)
Fever, cough, dyspnea, headache, abdominal pain, decreased activity
Fever, cough, dyspnea, congestion
Fever, cough
Fever, cough, decreased appetite
Hospital course
Site pathogen isolated Blood and pleural fluid Blood and pleural fluid Pleural fluid Blood
IV antimicrobial drugs, d 21 9 14 33
IV antimicrobial drugs (MIC, μg/mL) Cefotaxime (0.06) Vancomycin (0.75); ceftriaxone (0.19) Vancomycin (1); resistant to cephalosporin Vancomycin (0.50); ceftriaxone (0.064)
VATS† (duration, d) Yes (2) Yes (2) Yes (2) No
ICU stay Yes Yes No Yes
Intubated (duration, d) Yes (5) Yes (5) No Yes (22)
Duration of hospitalization, d
22
11
15
28
Oral antimicrobial drugs after discharge (duration, d) Cefdinir (7) Cefdinir (14) Linezolid (14) Cefdinir (7)

*PCV, pneumococcal conjugate vaccine; IV, intravenous; VATS, video-assisted thoracoscopic surgery; ICU, intensive care unit. Boldface indicates clinically significant differences.
†Hospitalization day that VATS was performed.

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