Background: Necrotizing pneumonia rarely occurs in children, but when it does it can be complicated by bronchopleural fistula, empyema, pneumothorax, sepsis, and acute respiratory distress syndrome (ARDS). Antimicrobial therapy is the cornerstone of its management; however, surgery is necessary in some cases. Ideally, surgical interventions are kept to a minimum, but this is not always possible if there is a mass effect from air and fluid in the pleural space, pulmonary necrosis leading to massive hemoptysis, uncontrolled sepsis, or difficulties with assisted ventilation.

中文翻译：

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支气管胸膜瘘并发肺炎球菌坏死性肺炎难治性脓气胸和急性呼吸窘迫综合征患者的表面活性剂

背景：坏死性肺炎很少发生在儿童身上，但一旦发生，它可能会并发支气管胸膜瘘、脓胸、气胸、败血症和急性呼吸窘迫综合征 (ARDS)。抗菌治疗是其管理的基石；然而，在某些情况下，手术是必要的。理想情况下，手术干预保持在最低限度，但如果胸膜腔内的空气和液体产生占位效应、肺坏死导致大量咯血、无法控制的脓毒症或辅助通气困难，这并不总是可行的。