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 2 Treatment timeline of the patient.
| Date | Event | Intervention | Clinical status | Key findings |
|---|---|---|---|---|
| March 20 | Initial admission | Chest CT scan | Clinically stable (SpO 98% on room air, 22 breaths/min) | human metapneumovirus infection and pneumonia confirmed, no pleural effusion |
| March 21 | Bronchoscopy | Bronchoalveolar lavage | Stable with ongoing fever | infection confirmed |
| March 22 | Antibiotic therapy initiated | Linezolid + ceftriaxone | Improving (fever resolving) | Clinical response to antibiotics |
| March 25 | Discharge | Continued oral antibiotics | Clinically improved | Afebrile, minimal respiratory symptoms |
| March 26 | Readmission | Contrast-enhanced chest CT | Worsening (abdominal pain, WBC and CRP elevated) | Necrotizing pneumonia and complicated pleural effusion |
| March 27 | Thoracoscopic surgery | Thoracoscopic exploration + closed drainage | Postoperative recovery | Approximately 100 mL purulent fluid drained |
| April 1 | Postoperative day 5 | Follow-up chest CT | Significantly improved | Pleural effusion reduced |
| April 10 | Follow-up visit | Chest CT scan | Clinically recovered | Marked improvement in pulmonary lesions |
| CT – computed tomography; WBC – white blood cells; CRP – C-reactive protein. | ||||