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Pleural empyema in infants and children: analysis of 298 cases
Insights
Empyema thoracis in young children is often linked to lung infections, with Staphylococcus aureus being a common cause. Prompt antibiotic treatment and catheter drainage effectively resolved most cases, though delayed care increased complications.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Thoracic Surgery
Background:
- Empyema thoracis is a significant respiratory condition in infants and children.
- Underlying pulmonary infections frequently precede empyema thoracis.
- Staphylococcus aureus is a predominant pathogen identified in these cases.
Purpose of the Study:
- To analyze the clinical characteristics, diagnosis, and management of empyema thoracis in a pediatric cohort.
- To identify factors influencing morbidity and mortality in pediatric empyema thoracis.
Main Methods:
- Retrospective review of 298 infants and children diagnosed with empyema thoracis.
- Diagnosis confirmed via chest X-ray and thoracentesis.
- Treatment involved antibiotics and catheter drainage; decortication was used in refractory cases.
Main Results:
- 62% of patients were under 2 years old.
- Staphylococcus aureus was the most common organism isolated.
- Antibiotics and catheter drainage led to full lung expansion and pneumonia resolution in most patients.
- The overall mortality rate was 5%.
Conclusions:
- Empyema thoracis in young children is frequently associated with underlying pneumonia and Staphylococcus aureus infection.
- Timely administration of appropriate antibiotics and effective catheter drainage are crucial for successful treatment.
- Delayed presentation and inadequate prehospitalization antibiotic use are associated with increased morbidity.
Abstract:
Of 298 infants and children with empyema thoracis seen, 62 percent were under 2 years of age. The majority of the cases had underlying pulmonary infection, and Staphylococcus aureus was dominant among the organisms isolated. The diagnosis was made in all cases on the basis of chest x-ray films and thoracentesis. Full expansion of the lung and resolution of the underlying pneumonia occurred on administration of appropriate antibiotics and catheter drainage in all cases except in two patients who had decortication. The mortality rate was 5 percent; delayed presentation and suboptimal prehospitalization antibiotics influenced the morbidity.