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[Pleural empyemas in children due to Hemophilus influenzae]
Insights
Haemophilus influenzae (H. influenzae) caused pleural empyema in young children, often with meningitis. Despite prolonged illness, prognosis was favorable, highlighting the importance of early bacterial diagnosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Pleural empyema is a serious condition in children.
- Haemophilus influenzae (H. influenzae) is a significant pathogen.
- Understanding empyema characteristics is crucial for management.
Purpose of the Study:
- To report on 22 cases of pediatric pleural empyema caused by H. influenzae.
- To analyze the clinical presentation, diagnosis, and prognosis.
- To identify risk factors and propose clinical characterization.
Main Methods:
- Retrospective review of 22 consecutive pediatric cases.
- Analysis of clinical data, including presentation, treatment, and outcomes.
- Bacteriological studies of blood and cerebrospinal fluid (CSF).
Main Results:
- H. influenzae was identified as the causative agent in pediatric pleural empyema.
- A notable increase in incidence was observed during 1975-76.
- Concurrent meningitis occurred in nearly 50% of cases.
- Low rates of pyopneumothorax, abscesses, and pneumotoceles were noted.
- Positive blood cultures were found in 75% of cases.
- Prolonged disease evolution but good prognosis compared to Staphylococcus aureus.
Conclusions:
- H. influenzae is a significant cause of pediatric pleural empyema, often associated with meningitis.
- Early bacteriological investigation of blood and CSF is vital in young children with pleural empyema.
- Pleuropulmonary complications are frequent in severe H. influenzae infections.
- Clinical characterization aids in identifying children at risk for empyema.
Abstract:
22 consecutive cases of pleural empyema due to H. influenzae in children are reported. An increment of its incidence during the 1975-76 period is observed. All cases were in children under 3 years of age, with a mean of 15.5 months. The presenting syndrome at admission was varied. In 50% of cases, pleuropulmonary infection was ignored. Nearly one half of cases of pleural empyema due to H. influenzae had simultaneous purulent meningitis caused by the same microorganism. This type of empyemas, though having a prolonged evolution, apparently appear to have a good prognosis, compared with that produced by S. aureus. There are some differences, being the most outstanding: low frequency of pyoneumothorax and the lack of radiological evidences of abscesses and or pneumotoceles, in any phase of the clinical course. Stress is placed on the value of the bacteriological study of blood and CSF in children under 3 years of age with pleural empyema. A high rate of positive blood cultures was found. (75%). Pieuropulmonary complications, as a frequent event during severe infections (septicemic disease) due to H. influenzae is considered. A clinical characterization of children in whom a pleural empyema could occur is proposed. A discussion is made about diagnostic, therapeutic and prognostic implications of these complications.