Related Experiment Videos

Update on the causes, investigation and management of empyema in childhood

Woolf Walker1, Robert Wheeler, Julian Legg

  • 1Regional Paediatric Respiratory Unit, Southampton University Hospitals NHS Trust, Southampton General Hospital, Tremona Road, Southampton, UK.

Archives of Disease in Childhood
|August 26, 2010
PubMed

Insights

Childhood empyema management is debated. Current evidence supports antibiotics followed by chest drain with urokinase, reserving video-assisted thoracoscopic surgery for treatment failures.

Area of Science:

  • Pediatrics
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Childhood empyema, a serious pleural infection, has increasing incidence globally.
  • Current management strategies for pediatric empyema lack universal consensus.
  • Despite its long history, optimal treatment pathways remain under investigation.

Purpose of the Study:

  • To review recent literature on the etiology and diagnosis of childhood empyema.
  • To critically evaluate current treatment options for pediatric empyema.
  • To propose a clinical practice guideline for empyema management.

Main Methods:

  • Comprehensive literature search of recent studies on childhood empyema.
  • Analysis of evidence regarding medical and surgical interventions.
  • Development of a treatment algorithm based on reviewed data.

Main Results:

  • Intravenous antibiotics are the initial step in management.
  • Chest drain insertion with urokinase instillation is recommended as first-line treatment.
  • Video-assisted thoracoscopic surgery (VATS) is indicated for cases unresponsive to initial medical therapy.

Conclusions:

  • A structured approach to childhood empyema management is proposed.
  • Early and appropriate intervention can improve outcomes.
  • The proposed algorithm aims to standardize care and guide clinical decisions.

Related Concept Videos

Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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 III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: