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Necrotising pneumonia, pneumatoceles and the pneumococcus
  1. Matthew F Thomas1,2,
  2. David A Spencer1
  1. 1School of Biology, Newcastle University, Newcastle-Upon-Tyne, UK
  2. 2Department of Respiratory Paediatrics, Great North Children’s Hospital, Newcastle-Upon-Tyne, UK
  1. Correspondence to Dr David Spencer, Department of Respiratory Paediatrics, Great North Children's Hospital, Newcastle-Upon-Tyne NE1 4LP, UK; david.spencer2{at}

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We commend Principi and Esposito for their timely review of severe community-acquired pneumonia in children.1 They state that the leading cause of necrotising pneumonia and pneumatoceles within the context of community acquired pneumonia is Staphylococcus aureus. We must disagree with this claim.

Historically, S aureus has been the principal organism associated with necrotic or cavitary pneumonia in children, but recent data demonstrate Streptococcus pneumoniae is now a much more important cause.2–4 …

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    Nicola Principi Susanna Esposito