Childhood parapneumonic pleural effusion in Enugu

To review the epidemiological pattern and clinical features, management and outcome of childhood parapneumonic pleural effusion in Enugu.

The records of the children with diagnosis of pleural effusion admitted at the University of Nigeria Teaching Hospital, Enugu between January 1995 and February 2001 were reviewed.

Forty out of forty two patients reviewed were analysed. There were 20 males, and 20 females (ratio of 1: 1), with age range of 3 months to 156 months (13 years) and the mean age of 4.99 years. The presenting symptoms were fever in 40 patients (100% ), cough in 38 (97.40% ), dyspnea in 36 (90.00% ), breathlessness in 27 (67.5% ), while, the most common physical sign was pallor. Thirty six children had diagnostic thoracocentesis. Twenty four (55.81% ) yielded pus, out of which, 10 grew organisms on culture; Streptococcus Pneumonia in 3, Staphylococcus aureus in 2, coliforms in 2, Haemophilus influenzae in 1, Proteus mirabilis in 1, Pseudomonas aeruginosa in 1. Nine patients received ampicillin/cloxacillin combination alone; 31 received ampicillin/cloxacillin with other antibiotics, including anti- tuberculous drugs in four children. Thirty-five of the children had thoracotomy, and one later had thoracotomy and decortication. Thirty-seven (92.5% ) were discharged home on recovery. The average admission duration was 24 days. Mortality rate was 7.50%.

In this review, there appears to be an evolving change in epidemiological pattern in comparison with the previous study from this center. There is need to improve on the diagnostic procedure and treatment modalities in order to establish definite criteria for antibiotic use and surgical intervention.