TITLE

Management of postpneumonic empyemas in children

AUTHOR(S)
Ozcelik, Cemal; Ülkü, Refik; Onat, Serdar; Ozcelik, Zerrin; Inci, Ilhan; Satici, Omer
PUB. DATE
June 2004
SOURCE
European Journal of Cardio-Thoracic Surgery;Jun2004, Vol. 25 Issue 6, p1072
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: Despite continued improvement in medical therapy, pediatric empyema remains a challenging problem for the surgeon. Multiple treatment options are available; however, the optimal therapeutic management has not been elucidated. The aim of this study is to assess different treatment options in the management of postpneumonic pediatric empyemas. Methods: A retrospective review was performed of pediatric patients admitted to Dicle University School of Medicine Thoracic and Cardiovascular Surgery Department between 1990 and 2002, with the diagnosis of empyema. Data tabulated included patient demographics, presentation, treatment and outcome. Results: There were 515 children (289 boys and 226 girls) with a mean age of 4.7 ranging from 18 days to 15 years. Empyema was secondary to pneumonia in all children. The most common radiologic finding was pleural effusion in 285 patients (55.32%). Staphylococcus aureus was the most frequently encountered organism and found in 105 patients (20.38%). Pleural fluid cultures were negative in 195 patients (37.86%). In addition to antibiotic therapy, initial treatment included serial thoracenthesis (n=29), chest tube drainage alone (n=214), chest tube drainage with intrapleural fibrinolytic therapy (n=72), chest tube drainage with primary operation (n=191), and primary operation without chest tube drainage (n=9). Overall response rate with fibrinolytic treatment (complete and partial response) was obtained in 58 patients. In addition to decortication pulmonary resections were performed in 12 patients. Overall mortality rate was 1.55%. There was no operative mortality. Postoperative morbidity included wound infection in 21, delayed expansion in 8, and atelectasis in 35 patients. Conclusions: Multiple therapeutic options are available for the management of pediatric empyema. Depending on stages, every option has a role in the treatment of postpneumonic pediatric empyema. In the absence of bronchopleural fistula, intrapleural fibrinolytic treatment should be tried in all patients with multiloculations in stage II empyema. In the absence of pneumonia, decortication for empyema is a safe approach with low mortality and morbidity rates.
ACCESSION #
13115593

 

Related Articles

  • Controversial funding mechanism to fight pneumonia. Braine, Theresa // Bulletin of the World Health Organization;May2008, Vol. 86 Issue 5, p325 

    The article focuses on the issue concerning the funds through Advanced Market Commitment (AMC) for childhood pneumonia prevention. According to the author, that there are more than two million children, aged five years and below, died from pneumonia annually and cites that mortality in children...

  • The low molecular weight heparin dalteparin for prophylaxis and therapy of thrombosis in childhood: a report on 48 cases. Nohe, N.; Flemmer, A.; Rümler, R.; Praun, M.; Auberger, K. // European Journal of Pediatrics. Supplement;1999, Vol. 158, pS134 

    We investigated the efficacy, safety and relation of dose to plasma anti-Xa activity of the low molecular weight heparin (LMWH) dalteparin in prophylaxis and therapy of arterial and venous thrombosis in pediatric patients. A total of 48 children were enrolled: 10 received dalteparin for...

  • Eosinophilic tumor in a patient with bronchial asthma receiving pranlukast. Watanabe, Toru; Iinuma, Yasufumi; Naito, Shin-ichi; Nitta, Koju // European Journal of Pediatrics;Feb2007, Vol. 166 Issue 2, p183 

    The article presents a case report of an eosinophilic inguinal tumor and eosinophilia in an eight-year-old boy with bronchial asthma. The tumor disappeared three months after the cessation of pranlukast therapy being undergone by the boy for the asthma. Pranlukast is included among drugs...

  • Impact of HIV-1 status on the radiological presentation and clinical outcome of children with WHO defined community-acquired severe pneumonia. Jeena, P. M.; Minkara, A. K.; Corr, P.; Bassa, F.; McNally, L. M.; Coovadia, H. M.; Fox, M.; Hamer, D. H.; Thea, D. // Archives of Disease in Childhood;Nov2007, Vol. 92 Issue 11, p976 

    Aims: We compared the radiological features and outcome of WHO defined severe pneumonia among HIV infected and exposed uninfected children randomised to receive penicillin or oral amoxicillin in Durban, South Africa. Methods: Of 425 children aged between 3 and 59 months with WHO defined severe...

  • Do boys do the atopic march while girls dawdle?  // Current Medical Literature: Respiratory Medicine;2008, Vol. 22 Issue 3, p74 

    The article discusses research being done on the influence of infantile eczema on the development of subsequent atopic asthma. It references a study by A. J. Lower et a, which appeared in a 2008 issue of the "Journal of Allergy and Clinical Immunology." Infantile eczema was determined to be a...

  • Outcome of HIV infected children with culture confirmed tuberculosis. Hesseling, A. C.; Westra, A. E.; Werschkull, H.; Donald, P. R.; Beyers, N.; Hussey, G. D.; El-Sadr, W.; Simon Schaaf, H. // Archives of Disease in Childhood;Nov2005, Vol. 90 Issue 11, p1171 

    Background: Tuberculosis (TB) is an important disease in human immunodeficiency virus (HIV) infected children living in regions where TB is endemic. There are limited data on the outcome of culture confirmed TB in HIV infected children. Aims and Methods: To describe the outcome on TB therapy and...

  • A Missed Cystic Fibrosis Diagnosis in Childhood. Leonardi, Salvatore; Sciuto, Concetta; Rosa, Mario La // Allergy & Asthma Proceedings;Nov/Dec2005, Vol. 26 Issue 6, p487 

    We describe a suggestive case of cystic fibrosis (CF) with a CF transmembrane conductance regulator (CFTR) mutation compatible with survival in which the diagnosis was missed in childhood A 46-year-old man presented to our pediatric hospital with infertility and chronic cough, which had been...

  • Pediatric Aerosol Therapy Guidelines. Alderson, Sheila Horan; Warren, Robert Hughes // Clinical Pediatrics;Oct1984, Vol. 23 Issue 10, p553 

    Delivery of medication in aerosol form to the pediatric population is an important therapeutic module. Aerosol therapy allows rapid medication effects, reduces systemic side effects, and provides uniform results in comparable clinical presentations if preparation techniques and dosages are...

  • Caution urged on LABAs for children.  // Pulse;12/17/2008, Vol. 68 Issue 44, p12 

    The article reports on the warning from experts regarding the use of long-lasting β-agonists (LABAs) in children in Great Britain. The warning came after a review found little evidence for their benefits. It states that many consensus guidelines suggest the use of LABAs as add-on therapy to...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics