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Pneumococcal empyema in childhood

J D Siegel, J C Gartner, R H Michaels

    American Journal of Diseases of Children (1960)
    |November 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Pneumococcal empyema in children was primarily caused by uncommon serotypes 1 and 3. Counterimmunoelectrophoresis (CIE) proved more effective than culture for diagnosis, especially after antibiotic treatment.

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    Area of Science:

    • Pediatric Infectious Diseases
    • Pulmonary Medicine
    • Clinical Microbiology

    Background:

    • Pneumococcal empyema is a serious lung infection in children.
    • Specific pneumococcal serotypes are rarely associated with pediatric infections but may cause severe disease.
    • Accurate and timely diagnosis is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the causative serotypes of pneumococcal empyema in pediatric patients.
    • To compare the diagnostic utility of counterimmunoelectrophoresis (CIE) and culture methods.
    • To evaluate the severity of empyema caused by different pneumococcal serotypes.

    Main Methods:

    • Retrospective analysis of pediatric empyema cases at Children's Hospital of Pittsburgh.
    • Serotyping of Streptococcus pneumoniae isolates from pleural fluid and blood cultures.

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  • Comparison of diagnostic results from CIE and traditional culture methods.
  • Assessment of clinical severity based on patient outcomes.

    • Main Results:

    • Two uncommon serotypes, types 1 and 3, accounted for the majority of empyema cases (8/10).
    • Type 3 pneumococcal empyemas were associated with increased disease severity.
    • Counterimmunoelectrophoresis (CIE) detected pneumococcal antigens in 7/10 culture-negative cases, often following prior antibiotic administration.
    • The Ouchterlony test showed potential utility in diagnosing a type 7 empyema case.

    Conclusions:

    • Streptococcus pneumoniae types 1 and 3 are significant, though uncommon, causes of pediatric empyema.
    • CIE offers a valuable diagnostic advantage over culture, particularly in culture-negative cases due to prior antibiotic use.
    • Prompt etiologic diagnosis using methods like CIE is essential for managing pediatric pneumococcal empyema.