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Necrotizing pneumonia (aetiology, clinical features and management)

Krutikov, Mariaa; Rahman, Anannab; Tiberi, Simona,c

Current Opinion in Pulmonary Medicine: May 2019 - Volume 25 - Issue 3 - p 225–232
doi: 10.1097/MCP.0000000000000571
INFECTIOUS DISEASES: Edited by Michael S. Niederman and Alimuddin Zumla

Purpose of review Necrotizing pneumonia is a severe form of community-acquired pneumonia characterized by rapid progression of consolidation to necrosis and cavitation which may lead to pulmonary gangrene. Morbidity and mortality are high and chronic sequelae are frequent. The lack of guidance supports the review of the latest recommendations in the management of these pneumonias.

Recent findings Antibiotic therapy alone may not be enough to alter the course of the infection, and regimens, adjunctive therapies like intravenous immunoglobulins, surgery may be required to alter the course of the disease especially with pulmonary gangrene.

Summary The causative agents, clinical features and management of necrotizing pneumonias are discussed.

aDivision of Infection, The Royal London Hospital

bDepartment of Respiratory Medicine, Barts Health NHS Trust

cBlizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK

Correspondence to Simon Tiberi, Division of Infection, The Royal London Hospital, Barts Health NHS Trust, 80 Newark Street, London E1 2ES, UK. E-mail:

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