Necrotizing pneumonia is a severe form of pneumonia caused by highly virulent bacteria, mainly streptococcus pneumoniae and staphylococcus aureus. Treatment is chiefly conservative, while surgical intervention is still controversial.
We report a unique case of necrotizing pneumonia due to group A streptococcus infection in an 18-month-old boy. Severe respiratory failure required extracorporeal membrane oxygenation (ECMO) support as a bridge to recovery. Following surgical lobectomy the child was weaned off ECMO and recovered uneventfully.
Cases of necrotizing pneumonia requiring ECMO support present a unique clinical challenge. A conservative approach includes watchful waiting for respiratory improvement while on ECMO support. However, an alternative approach stipulates surgical intervention to facilitate ECMO withdrawal.
Our patient’s necrotizing pneumonia was successfully treated by surgical lobectomy while he was on ECMO support. Thus, we suggest surgical lobectomy as a suitable option in select cases of necrotizing pneumonia not responding to conservative medical treatment.
