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Retrospective study of empyema cases in National Pediatric Hospital, Cambodia
Insights
Bacterial empyema is most common in Cambodian children, but tuberculosis empyema cases are older and require longer hospital stays. Delayed referrals contribute to the bacterial empyema fatality rate.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Empyema is a significant pediatric concern in Cambodia.
- The National Pediatric Hospital (NPH) in Phnom Penh serves as a key treatment center.
Purpose of the Study:
- To analyze the characteristics and outcomes of pediatric empyema cases at NPH.
- To differentiate between bacterial empyema (EB) and tuberculous empyema (ETB).
Main Methods:
- Retrospective analysis of empyema cases admitted to NPH between 1990-1993.
- Comparison of demographic, clinical, and outcome data between EB and ETB groups.
Main Results:
- Bacterial empyema constituted 95% of cases; tuberculous empyema accounted for 5%.
- Tuberculous empyema patients were older (mean 84.7 months vs. 52.5 months) and had longer hospitalizations (mean 32 days vs. 22 days).
- Overall bacterial empyema case fatality rate was 3%, linked to delayed referrals.
Conclusions:
- Bacterial causes dominate pediatric empyema in Cambodia.
- Tuberculous empyema presents differently, requiring longer treatment durations.
- Timely referral is crucial for improving outcomes in bacterial empyema.
Abstract:
Majority of empyema cases admitted into the National Pediatric Hospital (NPH), Cambodia were of bacterial origin (EB: 95%), the rest were caused by tuberculosis bacilli (ETB: 5%). The morbidity of overall empyema, empyema of bacterial origin and empyema of TB origin between boys and girls was the same, even though boys were more likely to be exposed than girls. The mean age of patients with ETB was significantly greater than those of EB, 84.7 +/- 46 months versus 52.5 +/- 37 months. Since NPH is located in Phnom Penh, most of our cases were from Kandal, Phnom Penh, and provinces nearby. On average all of the patients stayed in the hospital for 23.26 +/- 14.9 days (rank 1-91 days), and the mean duration of hospitalization of the ETB patients was significantly longer than that of EB patients, 32 +/- 19 days versus 22 +/- 14 days respectirely. The yearly incidence of empyema cases in 1990-1993 had the trend of slightly increased frequency during March to May. The overall EB case fatality rate was 3%, contributed to by delayed referral of cases.