Severe pneumococcal lung destruction in a child (case report)

Destructive (necrotizing) pneumonia is characterized by the formation of multiple areas of lung parenchyma necrosis within the inflammatory focus. These areas may merge to form an abscess if localized or, in extremely severe cases, progress to gangrene if the entire lobe is involved without clear boundaries of the inflammatory process. We report a clinical case of an extremely severe course of complicated pneumococcal pneumonia in a child aged 3 years and 8 months. Factors contributing to lung destruction in pediatric community-acquired pneumonia remain largely unidentified. The degree of perfusion impairment in the inflammatory focus is of critical importance. Irreversible changes in blood flow within pulmonary and bronchial vessels determine the severity and nature of localized changes, explaining the initial ineffectiveness of antibacterial therapy. Such developments occur due to a combination of two key conditions: infection with specific virulent pathogens and a specific host immune response, leading to severe pneumonia with destruction. A multidisciplinary approach, combining antibacterial and anticoagulant therapy with timely surgical intervention, allows for the avoidance of lung resection and minimizes the adverse consequences of the disease.KEYWORDS: destructive pneumonia, Streptococcus pneumoniae serotype 3, lung gangrene, necrosis, immunothrombosis, children. FOR CITATION: Tolstova E.M., Kuzina S.R., Besedina M.V., Emirova Kh.M., Zaitseva O.V., Zaitseva N.S., Elkina M.A., Yatsyshina S.B., Aminova A.A., Turishchev I.V., Khaspekov D.V., Sar A.S., Ganieva A.M., Sholokhova N.A., Tkachenko N.V., Olkhova E.B., Gorelov A.V. Severe pneumococcal lung destruction in a child (case report). Russian Journal of Woman and Child Health. 2026;9(1):77–87 (in Russ.). DOI: 10.32364/2618-8430-2026-9-1-10