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Management of Empyema thoracis in children--a study of 65 cases
Insights
Pediatric pleural empyema, often caused by Staphylococcus aureus, is successfully treated with antibiotics and chest tube drainage. Most children recover well, though some may require surgery.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Thoracic Surgery
Background:
- Pleural empyema is a significant respiratory infection in children.
- Pulmonary infections are the most common preceding condition.
Purpose of the Study:
- To analyze the clinical characteristics, causative agents, and treatment outcomes of pediatric pleural empyema.
- To evaluate the efficacy of current management strategies.
Main Methods:
- Retrospective review of 65 pediatric pleural empyema cases (1983-1986).
- Analysis of clinical presentation, microbiology, treatment interventions, and outcomes.
Main Results:
- Most cases (53/65) occurred in children under 10 years old.
- Staphylococcus aureus was the predominant pathogen (61% in pus).
- Antibiotics and tube thoracostomy achieved a 94% success rate; decortication was needed in 12%.
Conclusions:
- Pediatric pleural empyema is frequently associated with Staphylococcus aureus.
- Prompt antibiotic therapy and chest tube drainage are highly effective.
- Early intervention leads to favorable outcomes in most pediatric cases.
Abstract:
Sixty-five cases of pleural empyema (50 boys and 15 girls) were seen between January 1983 and June 1986. Fifty-three of these 65 children were below 10 years of age. Pulmonary infection was the commonest underlying cause. Cough with or without expectoration (98%) and fever (95%) were the commonest symptoms followed by breathlessness (85%) and chest pain (83%). Staphylococcus aureus was isolated from pus and blood in 61% and 18% of cases, respectively, while pseudomonas was grown in 8% and 3%. Most of the children (88%) were treated with antibiotics and tube thoracostomy drainage. Decortication was needed in 12% of cases. There were four deaths in this study. The overall success rate was 94%.