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[The diagnostic-therapeutic problems in acute suppurative destructive pleuropulmonary diseases in childhood]
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This study analyzes 183 children with acute purulent-destructive pleuropulmonary disease, finding mixed microbial flora and gram-negative bacteria as common causes. Treatment involved pleural puncture, drainage, or thoracotomy, with a 3.2% fatality rate.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Infectious Diseases
Background:
- Acute purulent-destructive pleuropulmonary disease is a significant pediatric condition.
- A ten-year retrospective study (1985-1994) examined 183 pediatric patients.
Purpose of the Study:
- To analyze the epidemiological characteristics, etiology, and treatment outcomes of acute purulent-destructive pleuropulmonary disease in children.
- To evaluate the effectiveness of various therapeutic interventions.
Main Methods:
- Retrospective analysis of 183 pediatric patients treated between 1985 and 1994.
- Diagnostic tools included roentgenography, contrast roentgenography, thoracoscopy, and computed axial tomography (CAT).
- Etiological agents were identified, and treatment strategies (pleural puncture, drainage, thoracotomy) were documented.
Main Results:
- The majority of patients were aged 1-15 years.
- Staphylococcus aureus, gram-negative flora, and mixed microbial flora were identified as primary etiological agents.
- Pleural drainage was the most common intervention (75.5%), followed by pleural puncture (12.5%) and thoracotomy (12.0%).
- A fatal outcome occurred in 3.2% of cases.
Conclusions:
- Acute purulent-destructive pleuropulmonary disease in children presents with diverse etiologies, often involving bacterial infections.
- Complex treatment strategies are necessary, with pleural drainage being a frequently employed method.
- While treatment can be effective, a small percentage of cases result in mortality.
Abstract:
Over a ten-year period (1985 through 1994), 183 children with acute purulent-destructive pleuropulmonary disease undergo treatment in the pediatric chest surgery department of the Medical Faculty-Sofia. Their distribution by age is as follows: 0-1 y. -28 children (15.2 per cent), 1-3 y.-67 (36.4 per cent), and 3-15 y. -88 (48.4 per cent). To assess the lung condition, and specify the form of disease and therapeutic approach, conventional and contrast roentgenography, thoracoscopy and CAT are performed. St. aureus is the etiological contributory cause in 28.9 per cent of patients, gram-negative flora-in 32.4 per cent, mixed microbial flora-in 33.2 per cent, and in the remainder no causing agent is isolated (15.5 per cent). All patients are subjected to complex treatment. In 23 children (12.5 per cent) the pleural complication is treated by pleural puncture, and in 138 (75.5 per cent)-by drainage of the pleural cavity. In 22 children (12.0 per cent) thoracotomy is done with varying in size pulmonary resection. In six children (3.2 per cent) the outcome is fatal.