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Empyema in children in tropics
Insights
Pediatric empyema, often linked to measles and malnutrition, showed a high mortality rate, especially with penicillin-resistant Staphylococcus infections. Prompt treatment with closed tube drainage and antibiotics improved recovery for survivors.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Pulmonology
Background:
- Empyema in children is a serious condition with significant morbidity and mortality.
- Measles bronchopneumonia and malnutrition were common comorbidities in pediatric empyema cases.
- Penicillin-resistant Staphylococcus aureus was a notable pathogen identified in a subset of patients.
Purpose of the Study:
- To report the incidence and clinical characteristics of pediatric empyema.
- To evaluate treatment outcomes and identify factors influencing mortality.
- To assess the role of specific antibiotic regimens and supportive care.
Main Methods:
- Retrospective analysis of 36 pediatric empyema cases over two years.
- Data collection on patient demographics, comorbidities, causative organisms, treatment modalities, and outcomes.
- Review of antibiotic sensitivities and treatment regimens, including closed tube drainage and parenteral antibiotics.
Main Results:
- Overall incidence of empyema was 0.11% of hospital admissions.
- 16 cases involved penicillin-resistant Staphylococcus infections.
- Mortality rate was significant, with most deaths occurring within three days of admission; survivors showed good recovery with supportive care.
Conclusions:
- Pediatric empyema, particularly with resistant pathogens, presents a critical challenge.
- Closed tube drainage combined with appropriate antibiotic therapy and supportive measures like blood transfusions is crucial.
- Further research into optimal management strategies for pediatric empyema is warranted.
Abstract:
Thirty-six cases of empyema were diagnosed in children over a two year period, giving an overall incidence of 0.11% of the total hospital admissions. Many of them had measles bronchopneumonia and most were malnourished. 16 children had penicillin resistant staphylococcal infection. 29 of them were treated with closed tube drainage. Thirteen died during the course of treatment, the majority within three days of admission. The rest were followed up over a period of up to six months and showed good recovery. Six of these patients developed pneumothorax during the course of treatment. Various combinations of Ampicillin, Cloxacillin, Gentamycin and Cotrimoxazole parenterally were used. Supportive treatment with blood transfusion was found to be beneficial.