Related Experiment Videos
Childhood empyema in North-East Scotland over the past 15 years
1Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, Westburn Road, Aberdeen. campbellroxburgh@doctors.net.uk
Insights
Paediatric empyema incidence is rising. Streptococcus pneumoniae serotype 1 is the most common cause, with no multi-drug resistance observed in North-East Scotland.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Thoracic Surgery
Background:
- Rising incidence of paediatric empyema in the UK and North America.
- Reasons for increasing admissions remain unclear.
- Management often requires tertiary care settings.
Purpose of the Study:
- To report on paediatric empyema cases managed in North-East Scotland over 15 years.
- To analyze patient characteristics, microbiology, and treatment outcomes.
- To compare local trends with national and international data.
Main Methods:
- Retrospective review of paediatric empyema patients (<15 years) admitted to Royal Aberdeen Children's Hospital (1990-2006).
- Data collection from case notes, including patient demographics, clinical presentation, microbiology, and treatment.
- Analysis of surgical interventions (open vs. thoracoscopic decortication) and hospital stay duration.
Main Results:
- 28 children admitted (mean age 6.8 years), with 27 presenting respiratory symptoms.
- Streptococcus pneumoniae was the most common isolate (12/28), with serotype 1 identified in 3/3 PCR-tested cases.
- 14/28 patients required surgery (8 open, 6 thoracoscopic decortication), with no observed complications. Mean hospital stay was 11.4 days.
Conclusions:
- Paediatric empyema trends in North-East Scotland mirror those reported globally.
- Streptococcus pneumoniae serotype 1 is the predominant pathogen.
- No multi-drug resistance was identified; a surveillance program is established to monitor incidence.
Introduction:
The incidence of paediatric empyema is rising in the United Kingdom and North America. The reasons for increasing admissions are unclear. Management in tertiary units is often required. We report our experience in North-East Scotland over the last 15 years.
Methods:
Empyema patients <15 yrs admitted to the Royal Aberdeen Children's Hospital between 1 st January 1990 and 1st June 2006 were identified using discharge coding. Data was collated from case notes. Patient characteristics, microbiology results, hospital stay and management are studied.
Results:
Twenty eight children (M:F = 1:1) were admitted. Mean age = 6.8 yrs. Twenty seven out of twenty eight presented with localising respiratory symptoms or signs. In 12/28 an organism was isolated. Streptococcus pneumoniae was the commonest isolate, and where polymerase chain reaction (PCR) testing was employed, 3/3 cases were serotype 1. Fourteen out of twenty eight required surgery: open (8/14) or thoracoscopic (6/14) decortication. Two thoracoscopic cases proceded to open decortication. No complications were observed. Mean hospital stay = 11.4 days. Twelve were managed in high dependency unit (HDU) with a mean stay of 7.1 days.
Discussion:
We demonstrate similar trends in North-East Scotland to those reported elsewhere. Serotype 1 streptococcus pneumoniae is the most isolated. Multi-drug resistance is not seen in our population. A surveillance programme is now established and reasons for the increasing incidence should become apparent.
Related Concept Videos
Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia I: Introduction
Brain Abscess l: Introduction
Bacterial Meningitis I: Introduction
Acute Pyelonephritis II: Diagnostic Studies and Management
Tonsillitis II: Management