Related Experiment Videos
Empyema thoracis in hospitalized children in Kelantan, Malaysia
1Department of Paediatrics, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Insights
This study reviewed 31 childhood empyema thoracis cases, finding Staphylococcus aureus as the most common pathogen. Effective treatment with antibiotics and chest drainage led to zero mortality and full radiographic resolution in followed patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Thoracic Surgery
Background:
- Empyema thoracis is a serious pleural space infection in children.
- Understanding causative pathogens and treatment outcomes is crucial for pediatric care.
- This study analyzes cases from a Malaysian hospital to provide local data.
Purpose of the Study:
- To retrospectively review childhood empyema thoracis cases.
- To identify common symptoms, radiographic findings, and causative pathogens.
- To evaluate treatment strategies and patient outcomes, including mortality and resolution.
Main Methods:
- Retrospective review of 31 childhood empyema thoracis cases.
- Analysis of patient demographics, clinical presentation, and diagnostic findings.
- Evaluation of treatment modalities (antibiotics, chest tube drainage, pleural tap) and outcomes.
Main Results:
- Staphylococcus aureus was the predominant pathogen (48%).
- Fever, cough, and dyspnea were frequent symptoms; radiography showed unilateral effusions.
- Treatment with intravenous antibiotics and chest tube drainage was most common, resulting in zero mortality and 100% radiographic resolution in follow-up cases.
Conclusions:
- Childhood empyema thoracis in this cohort was primarily caused by Staphylococcus aureus.
- Prompt treatment with antibiotics and chest drainage is effective, leading to favorable outcomes.
- The study highlights the importance of timely diagnosis and management in pediatric empyema thoracis.
Abstract:
In this study, 31 cases of childhood empyema thoracis admitted over 4 1/2 years to the Hospital Universiti Sains Malaysia, in Kelantan, Malaysia, were retrospectively reviewed. Twenty-two males and nine females were included, with a mean age of 1.9 years (range: 26 days to 7 years). Frequent symptoms were fever, cough, and dyspnoea, while common signs were temperature above 38 degrees C, decreased breath sounds, dullness to chest percussion, and intercostal recession. Radiography demonstrated unilateral moderate to large effusions in 68 per cent of cases, while consolidated lung was seen in 45 per cent of patients. Pleural fluid cultures were positive for Staphylococcus aureus (48 per cent), Streptococcus pneumoniae (7 per cent), while no growth was seen in 42 per cent of cases. Ninety-four per cent of children had a blood leukocytosis above 10 000 cell/mm3, but blood cultures were negative in 21 out of 26 patients (81 per cent). Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Antibiotics and pleural tap(s) were used in the remainder. Patients stayed in hospital for an average of 20.7 days (range: 4-52 days). Surgical intervention was necessary in only four children. The mortality rate at the time of discharge was zero, with 100 per cent radiographic resolution among the 23 patients who were followed-up.