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Empyema in children: a review of 52 cases
1Cardiothoracic Surgery, Medical School, University of Zimbabwe, Harare.
Insights
This study on pediatric empyema in Zimbabwe found that intrapleural drainage and antibiotics led to survival in all cases. Early intervention is key for treating childhood empyema effectively.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Thoracic Surgery
Background:
- Empyema is a serious thoracic infection in children.
- Limited data exists on pediatric empyema management in sub-Saharan Africa.
Purpose of the Study:
- To evaluate the clinical presentation, treatment strategies, and outcomes of pediatric empyema.
- To identify the primary causative pathogens and assess treatment efficacy.
Main Methods:
- A prospective study of 52 children admitted with empyema.
- Management involved intrapleural drainage and antibiotic therapy.
- Follow-up assessed clinical and radiological recovery.
Main Results:
- Staphylococcus aureus was the predominant pathogen.
- All patients survived the initial treatment.
- Two children required decortication.
- One child had persistent radiological abnormality and reduced exercise tolerance post-treatment.
Conclusions:
- Intrapleural drainage and antibiotics are effective primary treatments for pediatric empyema.
- Prompt management leads to favorable outcomes in most cases.
- This approach is recommended for children with empyema in resource-limited settings like Zimbabwe.
Abstract:
A prospective study was undertaken to assess the clinical pattern, management and outcome in children admitted with empyema at Harare Hospital. Fifty-two children were seen and followed up during the three-year period, 1984-1987. All patients were managed with intrapleural drain and antibiotics. Two needed decortication. The predominant pathogen isolated from the pleural cavity was Staphylococcus aureus. All survived and on follow up only one child was found to have persistent radiological abnormality and poor exercise tolerance. Early intrapleural drainage and appropriate antibiotics should be the mainstay of treatment for empyema for the majority of children in Zimbabwe.