25 April 2026
: Case report 
Streptococcus pyogenes-Induced Necrotizing Pneumonia With Pleural Effusion in a Child: Role of Medical Thoracoscopy
Unusual clinical course, Unusual setting of medical care
Lei Zhu E 1, Feizhou Zhang CD 2,3,4, Ting Huang AD 4,5, Fang Jin AC 2,3,4, Hujun Wu BD 2,3,4, Xiaofen Tao CF 2,3,4, Lei Wu BC 2,3,4, Lanfang Tang FG 2,4*DOI: 10.12659/AJCR.951007
Am J Case Rep 2026; 27:e951007
Table 1 Serial laboratory test results during her hospitalization.
| 15- Mar | 16- Mar | 17- Mar | 19- Mar | 20- Mar | 24- Mar | 25- Mar | 26- Mar | 30- Mar | 1- Apr | 4- Apr | 8- Apr | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| White blood cell (4–12×10/mL) | 8.1 | 8.07 | 10.74 | 9.05 | 15.62 | 16.24 | 19.96 | 8.04 | 5.31 | 7.57 | ||
| High-sensitivity C-reactive protein (0–8 mg/L) | 155.64 | 184.28 | 120.47 | 23.8 | 6.71 | 36.41 | 92.37 | 39.96 | 6.57 | 4.36 | ||
| D-dimer (<0.55 mg/L) | 3.24 | 1.16 | 1.51 | 1.12 | 3.69 | 10.61 | 3.69 | 0.95 | ||||
| Procalcitonin (0–0.46 ng/mL) | 38.26 | 1.28 | 0.15 | 0.19 | 0.09 | 0.07 | ||||||
| Erythrocyte sedimentation rate (0–20 mm/h) | 25.75 | |||||||||||
| Lactate dehydrogenase (110–295 U/L) | 382 | 272 | 24 | 122 | 430 | |||||||
| Alanine aminotransferase (<50 U/L) | 8 | 13 | 28 | 32 | 21 | |||||||
| Respiratory pathogen nucleic acid detection | Negative | |||||||||||
| Epstein-Barr virus antibody and DNA | Negative | |||||||||||
| Tuberculosis infection T cell detection | Negative | |||||||||||
| Blood culture | Negative | |||||||||||
| RNA of bronchial aspirate | Negative | |||||||||||
| MP + CP + LG antibody | Negative | |||||||||||
| RNA of BALF | Negative | |||||||||||
| Tuberculosis smear examination of BALF | Negative | |||||||||||
| DNA detection | ||||||||||||
| Pleural effusion pathogen targeted sequencing detection | Negative | |||||||||||
| Lavage fluid pathogen targeted detection | ||||||||||||