Volume 15, Number 10—October 2009
Letter
Severe Necrotizing Pneumonia in Children, Houston, Texas, USA
Anupama S. Kalaskar
, Gloria P. Heresi, Audrey Wanger, James R. Murphy, and Susan H. Wootton
, Gloria P. Heresi, Audrey Wanger, James R. Murphy, and Susan H. WoottonTable
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.
