[Pleurisy: diagnostic and therapeutic management].
Diagnosis of pleural effusion is difficult in children. The etiologies are numerous; however, infectious agents are more frequent. Thoracocentesis proves to be the first-line diagnostic tool. Light's criteria are the best for distinguishing whether the effusion is a transudate or an exudate. If the patient has an exudative pleural effusion, other tests are indicated to determine the etiology and in some cases the treatment: macroscopic appearance, cytology and differential white cell count (level of glucose, lactate dehydrogenase, adenosine deaminase, pH, bacterial cultures). Others investigations--biopsy of pleura by thoracoscopy or video-assisted thoracoscopy, bronchofibroscopy, CT scan--are sometimes useful. Intrapleural instillation of urokinase appears to be useful and safe. Evaluation is necessary for video-assisted thoracoscopy used early.
Sardet
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Service de pédiatrie, centre hospitalier Lens, France.
D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D004322:Drainage; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006491:Hemothorax / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D010996:Pleural Effusion / Q000175:diagnosis / Q000628:therapy; D010998:Pleurisy / Q000175:diagnosis / Q000628:therapy; D011001:Pleuropneumonia / Q000175:diagnosis / Q000628:therapy; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator