Lobectomy as curative treatment for refractory severe pneumonia with pulmonary necrosis in childhood

Abstract Introduction Necrotizing pneumonia is a severe complication of community-acquired pneumonia in pediatric patients, characterized by destruction of lung parenchyma and cavitation. While most cases respond to antibiotic treatment, some require surgical intervention. Case presentation We report a 2-year and 11-month-old male without significant comorbidities who presented with persistent fever, cough, and respiratory distress. Despite broad-spectrum antibiotics and pleural drainage, clinical deterioration persisted. Imaging showed extensive consolidation and necrosis of the left lower lobe. A left lower lobectomy was performed with favorable postoperative evolution. Discussion Necrotizing pneumonia is a rare but serious condition in children that may require lobectomy when medical management fails. Early recognition and timely surgical intervention are critical to improve outcomes. Literature supports lobectomy as a safe and effective treatment in selected cases. Conclusion Lobectomy is a definitive therapeutic option in pediatric patients with necrotizing pneumonia and extensive lung involvement refractory to medical treatment.