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Empyema thoracis in childhood in the tropics
N Sinzobahamvya1, M O Ikeogu, D A Zaal
1Mpilo Central Hospital, Bulawayo, Zimbabwe.
Insights
Simple drainage and povidone iodine irrigation effectively managed pediatric empyema thoracis in rural Zimbabwe. This cost-effective method showed good outcomes, with Staphylococcus aureus being the most common pathogen.
Area of Science:
- Pediatric infectious diseases
- Thoracic surgery
- Infectious disease management
Background:
- Empyema thoracis is a serious chest infection in children.
- Effective and accessible management strategies are crucial, especially in resource-limited settings.
- Traditional treatments can be invasive and costly.
Purpose of the Study:
- To evaluate a simple management approach for pediatric empyema thoracis.
- To assess the efficacy and safety of povidone-iodine irrigation.
- To determine the feasibility of this method in a rural Zimbabwean context.
Main Methods:
- A retrospective review of 25 children with empyema thoracis.
- 21 children were managed with simple drainage and continuous 0.1% povidone-iodine irrigation.
- Comparison with more aggressive surgical interventions.
Main Results:
- The povidone-iodine irrigation method was successful in most cases (17/21 survivors).
- Outcomes were excellent in 14 children and fair in 2.
- Staphylococcus aureus was the most frequently identified organism.
Conclusions:
- Simple drainage with povidone-iodine irrigation is an effective, safe, and easily implementable treatment for pediatric empyema thoracis in rural areas.
- The method demonstrated good results with minimal side effects.
- Surgical intervention was required for treatment failures.
Abstract:
The management of 25 children with empyema thoracis in Zimbabwe is discussed. The method adopted in 21 of these children using simple drainage and continuous irrigation with 0.1% solution of povidone iodine compared well with more aggressive methods. The method can be carried out easily in a rural environment. 2 of these 21 children died, one because of aspiration. The results among the survivors were good - excellent in 14 of the 21 children and fair in 2. There were no side effects attributable to the povidone iodine. The method failed in 3 patients who had to be dealt with surgically. Staphylococcus aureus was the commonest organism responsible for empyema.