[Empyema and pleural effusion in children].
BACKGROUND
Pleural empyema (PE) is a serious complication of community-acquired pneumonia (CAP).


OBJECTIVE
To describe the clinical profile of hospitalized patients with PE in the pediatric ward of the Catholic University Hospital between 2000-2005.


METHODS
Retrospectively, all pediatric admission due to CAP and pleural effusion (86 children) were identified. In 59 (70%) children > 1 thoracocentesis were performed. We considered PE as the presence in the pleural effusion of pus, and/or a positive gram strain and/ or positive culture, and/or a pH < 7.10. Children with effusions not meeting any criteria were used as controls.


RESULTS
Twenty four PE and 25 controls were identified, with a global mean age of 2.9 years (range: 8 months to 14.3 years); 78% were < 5 years, with a significant difference between PE and controls [1.6 vs 3.3 years (p = 0.01)]. The mean duration of symptoms in PE patients before admission was 7 days (range: 2-21), and the most frequent symptoms were fever (100%) and cough (96%). In 15/24 cases a microorganism was identified being Streptococcus pneumoniae (n = 9) the most common. In 48 patients management was conservative and in 4 surgical procedures were required. The mean duration of hospitalization was significantly higher in the PE group vs controls group: 15 (range: 5-38) vs 9 days (range 3-16) (p < 0.01). A chest tube was inserted in 83% of children with EP compared with 36% in the control group (p = 0.002). There were no difference in number of days of oxygen use [6 vs 4.5 (p = 0.36)] or number of chest tubes per child [3 vs 2.5 (p = 0.29)]. No deaths were reported.


CONCLUSIONS
PE in children represented an acute respiratory event associated with more prolonged hospitalization especially at younger ages; the majority of cases did not require surgical intervention.
Arancibia
M Francisca
MF
Unidad Broncopulmonar, Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile.
Vega-Briceño
Luis E
LE
Pizarro
M Ester
ME
Pulgar
Dahiana
D
Holmgren
Nils
N
Bertrand
Pablo
P
Rodríguez
José L
JL
Sánchez
Ignacio
I
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000150:complications / Q000382:microbiology; D016724:Empyema, Pleural / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D018410:Pneumonia, Bacterial / Q000150:complications* / Q000382:microbiology; D012189:Retrospective Studies