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Paediatric parapneumonic effusion - a twenty-year clinical narrative.
Leonie Bregy1, Philipp K A Agyeman1, Andrea Duppenthaler1
1Division of Paediatric Infectious Disease, Department of Paediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Paediatric parapneumonic effusion (PPE) management has evolved, with increased use of pleural drainage and shorter antibiotic courses. Streptococcus pneumoniae causes more lung damage than Streptococcus pyogenes in children with PPE.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Paediatric parapneumonic effusion (PPE) carries risks of sepsis and lung sequelae.
- Current treatment guidelines for PPE are lacking.
- Management strategies vary, impacting patient outcomes.
Purpose of the Study:
- To analyze trends in PPE management over time.
- To evaluate the influence of management strategies on short-term outcomes.
- To compare clinical differences in PPE caused by distinct pathogens.
Main Methods:
- Retrospective observational single-centre study.
- Analysis of 255 patients with PPE admitted between 2004 and 2024.
- Jonckheere-Terpstra test used for trend analysis.
Main Results:
- Pleural drainage increased from 20% to 65% over the study period.
- Intravenous antibiotic duration decreased from 15 to 11 days.
- Streptococcus pneumoniae was linked to greater lung damage, while Streptococcus pyogenes was more associated with sepsis/toxic shock.
Conclusions:
- Significant clinical differences exist between PPE caused by S. pneumoniae and S. pyogenes.
- S. pneumoniae infections result in more severe lung damage.
- Evolving management strategies may influence PPE outcomes.
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