Clinical characteristics of 323 children with parapneumonic pleural effusion and pleural empyema due to community acquired pneumonia

Abstract Background An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) in children has been found in several studies published in the last decades. The aim of the study was to evaluate the incidence, etiology, clinical features, treatment strategies and outcomes of PPE/PE...

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Published in:	Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2016-05, Vol.22 (5), p.292-297
Main Authors:	Krenke, Katarzyna, Urbankowska, Emilia, Urbankowski, Tomasz, Lange, Joanna, Kulus, Marek
Format:	Article
Language:	eng
Subjects:	Adolescent Child Child, Preschool Children Community-Acquired Infections - complications Community-Acquired Infections - epidemiology Drainage Empyema, Pleural - epidemiology Empyema, Pleural - etiology Female Hematology, Oncology and Palliative Medicine Humans Infant Length of Stay Male Pleural drainage Pleural effusion Pleural Effusion - epidemiology Pleural Effusion - etiology Pneumonia Pneumonia, Bacterial - complications Pneumonia, Bacterial - epidemiology Retrospective Studies Streptococcus pneumoniae
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Summary:	Abstract Background An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) in children has been found in several studies published in the last decades. The aim of the study was to evaluate the incidence, etiology, clinical features, treatment strategies and outcomes of PPE/PE in children treated in a referral pulmonary center in central Poland. Material and methods We performed a retrospective analysis of clinical, radiological and laboratory data of all children aged between 1 month and 18 years with PPE/PE due to community acquired pneumonia (CAP) between January 2002 and December 2013. Results One thousand nine hundred and thirty three children with CAP were hospitalized between 2002 and 2013. Parapneumonic effusion or PE was diagnosed in 323 children (16.7%). The proportion of children with CAP related PPE/PE increased from 5.4% in 2002 to 18.8% in 2013. Streptococcus pneumoniae was the most common causative microorganism, responsible for 66.7% cases of known etiology. All children were treated with antibiotics and in 22.6%, and 74.3% of the patients therapeutic thoracentesis, pleural drainage with or without intrapleural fibrinolysis was performed, respectively. Approximately 3% of patients required surgical intervention. Conclusions A significant increase in the incidence of PPE/PE in children with CAP treated in our institution in the last twelve years was found. S. pneumoniae was the most common causative microorganism. Antibiotic therapy with chest drain insertion ± intrapleural fibrinolysis is an effective treatment of PPE/PE and surgical intervention is seldom necessary. With proper management, the overall prognosis in children with CAP related PPE/PE is good.
ISSN:	1341-321X 1437-7780