Necrotizing pneumonia

Necrotizing pneumonia, also called cavitary pneumonia or cavitatory necrosis, is a rare but severe complication of an infection of the lung tissue. The affected lung tissue dies and largely liquefies, which can lead to gangrene in the lung. Most patients have fever, cough and bad breath, those with a slower infection may lose weight, and some arrive with acute respiratory failure. The pathogens most often responsible are Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae. Diagnosis usually rests on chest imaging, and a CT scan is the most sensitive test, showing loss of the normal lung architecture and many small thin-walled cavities; cultures from lavage fluid and blood may identify the organism. Management is mainly supportive care with suitable antibiotics, and surgical removal of lung tissue is a reasonable option when severe complications such as sepsis develop or medical therapy fails. This entry is not medical advice.