Alteplase in the treatment of complicated parapneumonic effusion: a case report.
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.
Bishop
Naomi B
NB
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
Pon
Steven
S
Ushay
H Michael
HM
Greenwald
Bruce M
BM
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*
D010959:Tissue Plasminogen Activator