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Outcome of parapneumonic empyema
S K Satpathy1, C K Behera, P Nanda
1Department of Pediatrics, M.K.C.G. Medical College, Berhampur, Orissa, India. sarojsat@yahoo.co.uk
Indian Journal of Pediatrics
|April 7, 2005
Summary
Chest tube drainage is a safe and effective primary treatment for pediatric empyema, with most cases resolving without surgery. This approach offers excellent recovery outcomes for children with this serious chest infection.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Infectious Diseases
Background:
- Empyema thoracis presents with varied demographics and causative agents, leading to management debates.
- Understanding current trends in pediatric empyema is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the current demography, bacteriology, and treatment outcomes of pediatric empyema thoracis.
- To evaluate the efficacy of different management modalities for parapneumonic empyema.
Main Methods:
- A prospective study was conducted on pediatric patients with parapneumonic empyema from July 2001 to June 2003.
- Treatment involved chest tube drainage, parenteral antibiotics, and thoracotomy for complex or non-improving cases.
Main Results:
- Empyema affected 0.8% of pediatric admissions, with females and underweight children being more susceptible.
- Staphylococcus aureus was the most common isolate; 90.5% of cases were managed successfully with antibiotics and chest tube drainage alone.
- Thoracotomy was required in 9.4% of cases, with salvage rates high; recovery was generally excellent with comparable fever remission and hospital stay.
Conclusions:
- Chest tube drainage is a safe and effective primary management strategy for pediatric empyema.
- Antibiotic therapy combined with chest tube drainage offers successful outcomes for the majority of patients.
- Surgical intervention like thoracotomy is reserved for specific indications and demonstrates good salvageability.