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Parapneumonic empyema in children: conservative approach

Erdal Yilmaz1, Yaşar Doğan, A Hakan Aydinoğlu

  • 1Department of Pediatrics, Firat University Faculty of Medicine, Elaziğ, Turkey.

The Turkish Journal of Pediatrics
|May 25, 2002
PubMed

Insights

Pediatric empyema, often caused by Staphylococcus aureus, can be successfully treated with antibiotics and chest tube drainage. Most children achieve full recovery within six months, with surgery rarely needed.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Empyema complicating pneumonia is a significant concern in pediatric populations.
  • Understanding the clinical spectrum, bacteriology, and treatment outcomes is crucial for effective management.

Purpose of the Study:

  • To investigate the clinical presentation, bacteriology, treatment strategies, and outcomes of pediatric empyema.
  • To identify factors influencing recovery and the necessity of surgical intervention.

Main Methods:

  • Retrospective study of 49 pediatric patients (3 months to 13 years) with empyema.
  • Analysis of clinical data, radiographic findings, microbiological results, treatment modalities, and patient outcomes.
  • Follow-up assessment of radiographic resolution at six months.

Main Results:

  • Fever and cough were the most common presenting symptoms.
  • Staphylococcus aureus was the most frequent pathogen identified; however, no organism was recovered in 67.3% of cases.
  • Intravenous antibiotics and chest tube drainage were the primary treatments, with decortication rarely performed.
  • The average hospitalization was approximately 28 days, with one mortality due to sepsis.
  • All followed patients showed complete or near-complete radiographic resolution by six months.

Conclusions:

  • Pediatric empyema can be effectively managed with appropriate antimicrobial therapy and closed chest tube drainage.
  • Aggressive surgical intervention is infrequently required for favorable outcomes.
  • Early diagnosis and prompt, adequate treatment lead to excellent long-term results in children.

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