title: Surgical treatment of children with necrotizing pneumonia.
abstract: OBJECTIVE
  To describe the results of the surgical treatment of children with necrotizing pneumonia.
  
  
  METHODS
  A retrospective analysis of the medical charts of 20 children diagnosed with necrotizing pneumonia and submitted to surgical treatment between March of 1997 and September of 2008 in the thoracic surgery departments of two hospitals in the city of Manaus, Brazil. We compiled data regarding age, gender, etiologic agent, indications for surgery, type of surgical resection performed, and postoperative complications.
  
  
  RESULTS
  The mean age of the patients was 30 months. Of the 20 patients studied, 12 (60%) were female. The most common etiologic agents were Staphylococcus aureus, in 5 patients (25%), and Klebsiella sp., in 2 (10%). The indications for surgery were sepsis, in 16 patients (80%), and bronchopleural fistula, in 4 (20%). The types of surgical procedures performed were lobectomy, in 12 patients (60%), segmentectomy, in 7 (35%), and bilobectomy, in 1 (5%). There were 8 patients (40%) who also underwent decortication. The postoperative complications were as follows: bronchopleural fistula, in 4 patients (20%); empyema, in 1 (5%); pneumatocele, in 1 (5%); and phlebitis of the left arm, in 1 (5%). Four (20%) of the patients died.
  
  
  CONCLUSIONS
  Surgical resection should be considered in patients with evidence of pulmonary necrosis. Resection is indicated in cases of severe sepsis, high output bronchopleural fistula, or acute respiratory failure that are refractory to clinical treatment.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brasil. f.l.westphal@uol.com.br
authors.forename: Fernando Luiz
authors.initials: FL
authors.lastname: Westphal
authors.forename: Luís Carlos de
authors.initials: LC
authors.lastname: Lima
authors.forename: José Corrêa Lima
authors.initials: JC
authors.lastname: Netto
authors.forename: Eugênio
authors.initials: E
authors.lastname: Tavares
authors.forename: Edson de Oliveira
authors.initials: Ede O
authors.lastname: Andrade
authors.forename: Márcia dos Santos da
authors.initials: Mdos S
authors.lastname: Silva
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000473:pathology*; D008297:Male; D009336:Necrosis; D018410:Pneumonia, Bacterial / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D012140:Respiratory Tract Diseases / Q000145:classification / Q000209:etiology*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000009:adverse effects* / Q000145:classification