Journal of Paediatrics and Child Health
Volume 40 Issue 1-2 Page 69 - January 2004

To cite this article: AB Cengiz, G Kanra, M Cag^lar, A Kara, S¸ Güçer, T İnce (2004)
Fatal necrotizing pneumonia caused by group A streptococcus
Journal of Paediatrics and Child Health 40 (1-2), 69–71.
doi:10.1111/j.1440-1754.2004.00296.x

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Original Article
Fatal necrotizing pneumonia caused by group A streptococcus
AB Cengiz 1 1Pediatric Infectious Disease, and , G Kanra 1 1Pediatric Infectious Disease, and , M Cag^lar 22Pediatric
Pathology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, Turkey, A Kara 1 1Pediatric Infectious Disease,
and , S¸ Güçer 22Pediatric Pathology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, Turkey and T İnce 1
1Pediatric Infectious Disease, and Departments of 1Pediatric Infectious Disease, and 2Pediatric Pathology, Hacettepe
University Faculty of Medicine, Sıhhiye, Ankara, Turkey
Dr AB Cengiz, Department of Pediatrics, Division of Pediatric Infectious Disease, Ihsan Dog^ramacı Children's Hospital,
Hacettepe University Sıhhiye 06100, Ankara, Turkey. Fax: +90 312 3243284; email: ateskara@hacettepe.edu.tr
Abstract
Abstract:  Group A streptococcus (GAS) causes invasive, non-invasive and non-suppurative diseases. Pneumonia is
one of the invasive infections caused by GAS. Although GAS is a significant and serious cause of childhood pneumonia,
it is often overlooked clinically. Similarly, the recent literature is surprisingly scant on reports of GAS pneumonia and
concentrates mainly on varicella-associated invasive GAS diseases. In this case report, we present a previously healthy
7-year-old child with community-acquired pneumonia that progressed rapidly and resulted in sepsis, respiratory failure
and death. In both blood and pleural fluid cultures, Streptococcus pyogenes were isolated. On autopsy, macroscopic
examination revealed that the lung tissue appeared to have lost its normal architecture. Necrosis was present and the
lung had a spongy appearance with some solid areas. The light microscopy revealed massive oedema, haemorrhages,
intense inflammatory cell infiltration and necrosis. This case report highlights the need for consideration of invasive GAS
infection in the event of severe, rapidly progressing pneumonia in children.