Abstract
Objective: Empyema thoracis is known to have variable age group affection, causative agents and controversy regarding primary mode of management. To look into current demography, bacteriology and treatment outcome.Methods: Prospective study made on admitted cases of parapneumonic empyema from July 2001 to June 2003. All cases were treated with chest tube drainage, parenteral antibiotics or thoracotomy in multiloculated or non-improving cases.Results: 0.8% (C.I. 0.6–1.0) of total pediatric admission had empyema, who were more likely to be females (P<0.05), under-weight (P<0.05) compared to children admitted for other reasons.Staphylococcus aureus is still the commonest isolate (13.2%). All cases received antibiotics prior to hospitalisation. Majority of cases (90.5%) could be successfully managed with antibiotics and chest tube drainage alone. 9.4% cases needed thoracotomy. 5.8% cases needed salvage thoracotomy following non-improvement with chest tube drainage. Fever remission time and duration of hospital stay were comparable in both groups. Thoracotomy cases required antibiotics for shorter period (P=0.04). Two cases died due to reasons other than mode of management. Radiological and lung function recovery was excellent in most of the cases.Conclusion: Chest tube drainage is a safe, efficacious primary method of empyema management.
Similar content being viewed by others
Abbreviations
- CTD:
-
Chest Tube Drainage
References
Shankar KR, Kenny SE, Okoye BO, Carty HM, Lloyd DA, Losty PD. Evolving experience in the management of empyema thoracis.Acta Pediatr 2000; 89(4): 417–420.
Chen LE, Langer JC, Dillon PA, Foglia RP, Huddleston CB, Mendeloff ENet al. Management of late stage parapneumonic empyema.J Pediatr Surg 2002; 37(3): 371–374.
Meier AH, Smith B, Raghvan A, Moss RL. Rational treatment of empyema in children.Arch Surg 2000; 135(8): 907–912.
Huang FL, Chen PY, Ma JS, Yn HW, Lu KC, Chi CSet al. Clinical experience in managing empyema thoracis in children.J Microbiol Immunol Infect 2002; 35(2): 115–120.
Chan PW, Crawford O, Wallis C, DinWiddie R. Treatment of pleural empyema.J Pediatr Child Health 2000; 36 (4): 375–377.
Yilmaz E, Dogan Y, Aydinoglu AH, Gurgoze MK, Aygun D. Para pneumonic empyema in children: Conservative approach.Turkey J Pediatr 2002; 44(2): 134–138.
Raju PS, Prasad KVV, Venkata Ramana Y, Ahmed SK, Murthy KJR. Study of lung function tests and prediction equations in Indian male children.Indian Pediatr 2003; 40: 705–711.
Padmini R, Srinivasan S, Puri RK, Nalini P. Empyema in infancy and early childhood.Indian Pediatr 1990; 27: 447–452.
Kumar L, Gupta AP, Mitra S, Yadav K, Pathak IC, Walia BS, Kumar V, Ayagari A. Profile of childhood empyema thoracis in north India.Indian J Med Res 1980; 72: 854–859.
Arya LS, Khalju AZ, Fazal MI, Singh M. A study of empyema thoracis in children.Indian Pediatr 1982; 19: 917–920.
Paz F, Cespedes F, Cuevas M, Lecorre N, Navarro N. Pleural effusion and complicated empyema in children, evolution and prognostic factors.Rev Med Chil 2001; 129(11): 1289–1296.
Hardie W, Bokulic R, Garcia VF, Reising SF. Pneumococcal pleural empyemas in children.Clin Infect Dis 1996; 22(6): 1057–1063.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Satpathy, S.K., Behera, C.K. & Nanda, P. Outcome of parapneumonic empyema. Indian J Pediatr 72, 197–199 (2005). https://doi.org/10.1007/BF02859254
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02859254