Successful early venovenous extracorporeal membrane oxygenation in severe acute respiratory distress syndrome due to pneumococcal pneumonia in an adolescent girl: A case report

Streptococcus pneumoniae, a leading cause of bacterial community-acquired pneumonia in children, often responds to standard antimicrobial therapy. It can occasionally progress to acute respiratory distress syndrome requiring advanced life support, including extracorporeal membrane oxygenation (ECMO). A previously healthy 14-year-old girl with worsening pneumococcal pneumonia progressed to respiratory failure, requiring invasive mechanical ventilation. Despite optimized positive end-expiratory pressure, proning, and maximal ventilator support, persistent hypoxemia necessitated venovenous ECMO (VV-ECMO) initiation. She was successfully decannulated, transitioned to noninvasive respiratory support by day 16, and discharged in stable condition. This case report highlights fulminant pneumococcal pneumonia requiring VV-ECMO support with favorable outcome.