title: Intrapleural streptokinase in a two-year-old child with a parapneumonic effusion.
abstract: A two-year-old child was hospitalised with features of parapneumonic effusion. He was initially managed with parenteral antibiotics and chest tube drainage. After three days drainage became insignificant inspite of chest tube being patent and appropriately positioned. CT scan of chest showed multiloculated effusion. In view of multiloculated effusion it was decided to try intrapleural fibrinolysis with streptokinase. Streptokinase in a dose of 1,25000 IU dissolved in 50 ml of normal saline was instilled through the chest tube daily. After instilling three doses, there was a significant increase in the drainage followed by almost complete radiological resolution. There were no side effects. Intrapleural streptokinase is a useful adjunctive threapeutic modality in the management of complicated parapneumonic effusion or empyema in paediatric patients.
authors.affiliation: Department of Medicine, Base Hospital, Delhi Cantt, Delhi, India. msbharthwal@rediffmail.com
authors.forename: M S
authors.initials: MS
authors.lastname: Barthwal
mesh_terms: D015505:Chest Tubes; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003287:Contrast Media; D004305:Dose-Response Relationship, Drug; D004322:Drainage / Q000379:methods; D004334:Drug Administration Schedule; D004653:Empyema / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007322:Instillation, Drug; D008297:Male; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D013300:Streptokinase / Q000008:administration & dosage* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005343:Fibrinolytic Agents; D013300:Streptokinase