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Paediatric empyema: a case report and literature review

S J Parsons1, E Fenton, M Williams

  • 1Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania. simon.parsons@dhhs.tas.gov.au

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|March 22, 2006
PubMed

Insights

Aggressive early thoracotomy for pediatric Pneumococcal pneumonia with parapneumonic effusions offers faster recovery. While conservative treatments are an option, delayed drainage increases risks for children with empyema.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Parapneumonic effusions and empyema are serious complications of pneumonia.
  • Bilateral effusions present unique management challenges, especially in pediatric cases.

Purpose of the Study:

  • To present a case of bilateral parapneumonic effusions in a child with Pneumococcal pneumonia and bacteremia.
  • To review and discuss management strategies for pediatric empyema.

Main Methods:

  • Literature review of peer-reviewed articles on empyema management in children and adults.
  • Analysis of treatment outcomes comparing thoracotomy, VATS, and chest tube drainage.

Main Results:

  • Clinical and radiological staging of parapneumonic effusions is challenging.
  • Thoracotomy with decortication may offer superior outcomes in children compared to VATS or chest tube drainage regarding hospital stay and chest tube duration.
  • Simple chest tube drainage and antibiotics are effective for many cases.

Conclusions:

  • Initial conservative management for empyema is viable to avoid thoracotomy's disadvantages.
  • Delayed surgical intervention for empyema in children can lead to increased morbidity and mortality.
Abstract

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