ArticleFrontiers in medicine2026
Development and validation of a nomogram for differentiating bacterial from non-bacterial necrotizing pneumonia in children: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Necrotizing pneumonia (NP) in children requires etiology-dependent treatment, yet early etiological differentiation remains challenging due to the low sensitivity and slow turnaround of conventional microbiological methods. This study aimed to develop and validate a nomogram for predicting non-bacterial NP using routinely available clinical parameters. Methods: This single-center retrospective study enrolled children (<18 years) with contrast-enhanced computed tomography (CT)-confirmed NP at Tianjin Children's Hospital (January 2020-January 2025). Patients were classified as bacterial NP (BNP) or non-bacterial NP (NBNP) based on pathogen identification via culture, polymerase chain reaction (PCR), or targeted next-generation sequencing, and randomly split into training and validation sets (7:3). Predictors were selected by univariable screening followed by stepwise multivariable logistic regression, and a nomogram was constructed. Performance was assessed using receiver operating characteristic (ROC) analysis, calibration plots, and decision curve analysis. Results: Of 149 children (76 BNP, 73 NBNP; training Conclusion: A parsimonious nomogram based on fever duration, WBC count, and CRP level offers a practical bedside tool for early etiological differentiation of NP in children, potentially guiding timely pathogen-directed therapy before microbiological confirmation. External multicenter prospective validation is warranted.
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