title: Alteplase in the treatment of complicated parapneumonic effusion: a case report.
abstract: The treatment of complex parapneumonic effusions in children remains controversial, with some advocating less invasive, strictly medical management and others supporting a more aggressive approach of thoracotomy with or without decortication. Recent advances, including video-assisted thoracoscopic surgery and intrapleural fibrinolytic therapy, offer new options for effective treatment. We report the first case of successful resolution of a complex parapneumonic effusion in a 16-month-old girl with the use of tissue plasminogen activator (alteplase), infused via a catheter in the pleural space.
authors.affiliation: New York Presbyterian Hospital, Weill Medical College of Cornell University, Division of Critical Care, Department of Pediatrics, New York, New York 10021, USA. nbbishopmd@yahoo.com
authors.forename: Naomi B
authors.initials: NB
authors.lastname: Bishop
authors.forename: Steven
authors.initials: S
authors.lastname: Pon
authors.forename: H Michael
authors.initials: HM
authors.lastname: Ushay
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Greenwald
mesh_terms: D002673:Child, Hospitalized; D005260:Female; D006801:Humans; D007223:Infant; D010996:Pleural Effusion / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator