Severe pneumococcal lung destruction in a child (case report)
DOI: 10.32364/2618-8430-2026-9-1-10
E.M. Tolstova1, S.R. Kuzina 1, M.V. Besedina 1, Kh.M. Emirova1,2, O.V. Zaitseva1, N.S. Zaitseva1, M.A. Elkina2, S.B. Yatsyshina2, A.A. Aminova1, I.V. Turishchev3, D.V. Khaspekov3, A.S. Sar3, A.M. Ganieva3, N.A. Sholokhova3,4, N.V. Tkachenko3, E.B. Olkhova1,3, A.V. Gorelov1,2,5
1Russian University of Medicine, Moscow, Russian Federation
2Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation
3St. Vladimir Children's City Clinical Hospital, Moscow, Russian Federation
4Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
5I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow,
Russian Federation
Destructive (necrotizing) pneumonia is characterized by the formation of multiple areas of lung parenchyma necrosis within the inflammatory focus. These areas may merge to form an abscess if localized or, in extremely severe cases, progress to gangrene if the entire lobe is involved without clear boundaries of the inflammatory process. We report a clinical case of an extremely severe course of complicated pneumococcal pneumonia in a child aged 3 years and 8 months. Factors contributing to lung destruction in pediatric community-acquired pneumonia remain largely unidentified. The degree of perfusion impairment in the inflammatory focus is of critical importance. Irreversible changes in blood flow within pulmonary and bronchial vessels determine the severity and nature of localized changes, explaining the initial ineffectiveness of antibacterial therapy. Such developments occur due to a combination of two key conditions: infection with specific virulent pathogens and a specific host immune response, leading to severe pneumonia with destruction. A multidisciplinary approach, combining antibacterial and anticoagulant therapy with timely surgical intervention, allows for the avoidance of lung resection and minimizes the adverse consequences of the disease.
Keywords: destructive pneumonia, Streptococcus pneumoniae serotype 3, lung gangrene, necrosis, immunothrombosis, children.
For citation: Tolstova E.M., Kuzina S.R., Besedina M.V., Emirova Kh.M., Zaitseva O.V., Zaitseva N.S., Elkina M.A., Yatsyshina S.B., Aminova A.A., Turishchev I.V., Khaspekov D.V., Sar A.S., Ganieva A.M., Sholokhova N.A., Tkachenko N.V., Olkhova E.B., Gorelov A.V. Severe pneumococcal lung destruction in a child (case report). Russian Journal of Woman and Child Health. 2026;9(1):77–87 (in Russ.). DOI: 10.32364/2618-8430-2026-9-1-10
About the authors:
Evgeniya M. Tolstova — C. Sc. (Med.), Associate Professor of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0001-8340-3064
Sofya R. Kuzina — postgraduate student of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0002-8565-266X
Marina V. Besedina — C. Sc. (Med.), Associate Professor of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya st., Moscow, 127006, Russian Federation; ORCID iD 0000-0003-1160-7855
Khadizha M. Emirova — Professor of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0002-7523-5889
Olga V. Zaitseva — Dr. Sc. (Med.), Professor, Head of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0003-3426-3426
Nadezhda S. Zaitseva — C. Sc. (Med.), Associate Professor of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0003-1868-1396
Mariya A. Elkina — Junior Researcher at the Laboratory of Molecular Diagnostics and Epidemiology of Respiratory Tract Infections, Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0003-4769-6781
Svetlana B. Yatsyshina — C. Sc. (Bio.), Head of the Laboratory of Molecular Diagnostics and Epidemiology of Respiratory
Tract Infections, Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0003-4737-941X
Aziza A. Aminova — Clinical Resident of the Department of Pediatrics, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0009-0004-3040-9883
Ilya V. Turishchev — Head of the Intensive Care Unit, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0002-5277-9808
Dmitriy V. Khaspekov — C. Sc. (Med.), Head of the Thoracic Surgery Department, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0002-6808-7670
Artur S. Sar — thoracic surgeon, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0002-8959-2457
Alla M. Ganieva — radiologist, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0009-0002-5435-1204
Nataliya A. Sholokhova — Dr. Sc. (Med.), Professor of the Department of Diagnostic Radiology, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., build. 1, Moscow, 125993, Russian Federation; Head of the Diagnostic Radiology Department, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0002-0412-4938
Nadezhda V. Tkachenko — pulmonologist, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0003-4240-0072
Elena B. Olkhova — Dr. Sc. (Med.), Professor of the Department of Diagnostic Radiology, Russian University of Medicine; 4, Dolgorukovskaya st., Moscow, 127006, Russian Federation; Head of the Ultrasound Diagnostics Department, St. Vladimir Children's City Clinical Hospital; 12A, Matrosskaya Tishina str., Moscow, 107014, Russian Federation; ORCID iD 0000-0003-3757-8001
Alexander V. Gorelov — Academician of the RAS, Dr. Sc. (Med.), Head of the Department of Infectious Diseases and Epidemiology, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; Deputy Director for Science, Central Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; Professor of the Department of Children's Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0001-9257-0171
Contact information: Evgeniya M. Tolstova, e-mail: tepec@yandex.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 23.12.2025.
Revised 12.01.2026.
Accepted 30.01.2026.
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