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Experience in treating severe community-acquired pneumonia with suppurative complications

https://doi.org/10.18093/0869-0189-2026-36-4-719-727

Abstract

Severe community-acquired pneumonia (SCAP) remains a global medical and social problem, consistently ranking as a leading cause of admission to intensive care units (ICUs) and mortality. The severity criteria for pneumonia, as defined by international guidelines (IDSA/ATS) and Russian clinical recommendations, include the need for respiratory support, the presence of septic shock signs, and organ dysfunction. These factors necessitate a shift in treatment strategy, typically involving a revision of systemic antibiotic therapy and the implementation of measures to support vital bodily functions. Of particular significance are SCAP complications involving lung tissue destruction, such as the formation of lung abscesses, pleural empyema, and bronchopleural fistulas, which require a multidisciplinary approach to management. The aim was to present and analyze clinical experience in managing patients with severe community-acquired pneumonia complicated by suppurative processes. This includes evaluating the efficacy of applied diagnostic and therapeutic algorithms utilizing systemic antimicrobial and efferent therapy alongside invasive drainage procedures. Conclusion. Successful management of severe community-acquired pneumonia with suppurative complications requires a multidisciplinary approach. Key factors include timely adjustment of antibacterial therapy, the use of detoxification methods (e.g., lipopolysaccharide sorption), and early surgicaldrainage. The integration of conservative and invasive methods within a collaborative teamwork can improve outcomes in this category of patients.

About the Authors

E. V. Samoylenko
Regional State Budgetary Healthcare Institution “Vladivostok Clinical Hospital No.1”
Russian Federation

Elena V. Samoylenko, Pulmonologist of the highest qualification category, Head of the Pulmonology Department; tel.: (964) 435-13-67

ul. Sadovaya 22, Vladivostok, 690078, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



P. A. Knyazenko
Regional State Budgetary Healthcare Institution “Vladivostok Clinical Hospital No.1”
Russian Federation

Pavel A. Knyazenko, Deputy Chief Physician for Anesthesiology and Resuscitation; tel.: (423) 245-26-01

ul. Sadovaya 22, Vladivostok, 690078, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



V. A. Nevzorova
Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Vera A. Nevzorova, Doctor of Medicine, Professor, Director, Institute of Therapy and Instrumental Diagnostics; tel.: (914) 790-48-52

Prospekt Ostryakova 2, Vladivostok, 690002, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



E. M. Zhidkov
Regional State Budgetary Healthcare Institution “Vladivostok Clinical Hospital No.1”
Russian Federation

Egor M. Zhidkov, Chief Physician; tel.: (423) 245-26-01

ul. Sadovaya 22, Vladivostok, 690078, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



A. G. Shkuratov
Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation; State Budgetary Healthcare Institution “Regional Clinical Hospital No.2”
Russian Federation

Aleksandr G. Shkuratov, Associate Professor, Institute of Surgeryn; Thoracic Surgeon; tel.: (914) 704-30-33

Prospekt Ostryakova 2, Vladivostok, 690002, Primorskiy kray

ul. Russkaya 55, Vladivostok, 690105, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



V. A. Zevakina
Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Valeria A. Zevakina, Clinical Resident, Institute of Therapy and Instrumental Diagnostics; tel.: (994) 022-44-39

Prospekt Ostryakova 2, Vladivostok, 690002, Primorskiy kray


Competing Interests:

No conflict of interest is declared by the authors.



References

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6. Shoykhet Ya.N., Tseimakh E.A. [Treatment of infectious diseases of the pleura: parapneumonic pleurisy, pleural empyema]. In: Chuchalin A.G., ed. [Respiratory medicine: manual]. 3rd Edn. Moscow: PulmoMedia; 2024. Vol. 4: 138–157. DOI: 10.18093/978-5-60-52509-1-3-2024-4-138-157.

7. Ministry of Health of the Russian Federation. [Clinical guidelines: Pleural empyema]. 2024. Available at: http://www.thoracic.ru/wp-content/uploads/2024/03/КР-ЭМПИЕМА-ПЛЕВРЫ.-ЗАКЛЮЧИТЕЛЬНЫЙ-ВАРИАНТ.pdf [Accessed: February 09, 2026].


Review

For citations:


Samoylenko E.V., Knyazenko P.A., Nevzorova V.A., Zhidkov E.M., Shkuratov A.G., Zevakina V.A. Experience in treating severe community-acquired pneumonia with suppurative complications. PULMONOLOGIYA. 2026;36(4):719-727. (In Russ.) https://doi.org/10.18093/0869-0189-2026-36-4-719-727

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)