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The etiology of extensive pleural effusions with troublesome clinical course among children

Luís Marcelo Inaco Cirino1, Filumena Maria da Silva Gomes, Bernardo Nogueira Batista

  • 1University Hospital, Universidade de São Paulo, São Paulo, Brazil. marcelocirino@uol.com.br

Sao Paulo Medical Journal = Revista Paulista De Medicina
|February 5, 2005
PubMed

Insights

Complicated parapneumonic pleural effusion in children, often caused by Streptococcus pneumoniae, requires surgical intervention. Despite similar bacteriology to non-complicated cases, outcomes are worse, necessitating further research.

Area of Science:

  • Pediatric Infectious Diseases
  • Pulmonology
  • Surgical Pathology

Background:

  • Pneumonia is a leading infectious cause of mortality in children in São Paulo.
  • Parapneumonic pleural effusion is a common complication requiring surgical treatment if antibiotic therapy fails.

Purpose of the Study:

  • To investigate the etiological factors of complicated parapneumonic pleural effusions in children necessitating surgical intervention.

Main Methods:

  • A retrospective analysis of 117 cases of pediatric pleural empyema requiring surgery between 1986 and 1996.
  • Evaluation of clinical condition, radiological findings, nutritional and immunization status, prior antimicrobial therapy, and pleural effusion bacterioscopy.

Main Results:

  • Streptococcus pneumoniae was the most frequently identified pathogen in both blood and pleural fluid cultures.
  • Previous antibiotic use was found to negatively impact culture positivity.

Conclusions:

  • The bacteriological profile of complicated pneumonia cases mirrors that of non-complicated pneumonia.
  • Despite similar causative agents, children with complicated effusions experienced worse outcomes, suggesting factors beyond antibiotic resistance.
  • Further research is needed to elucidate the reasons for poorer outcomes in these pediatric patients.
Abstract

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