[Pleural effusion in children with pneumonia: a study of 63 cases].
BACKGROUND
An increase in the number and severity of pleural effusions has been observed in the last few years. The aim of the study is to describe the epidemiological characteristics, clinical findings and the treatment of this disease.


METHODS
This is a retrospective study of patients admitted into the PICU in Hospital Niño Jesús with parapneumonic pleural effusion from January 2005 to May 2006.


RESULTS
Sixty-three patients were included in the study. An increase of 29 % was observed in the number of patients admitted with parapneumonia effusion from 2005 to 2006. The most common aetiology was Streptococcus pneumoniae. In 65 % of patients pleural effusion was an empyema and in 33 % it was an exudate. In all patients with C-reactive protein below 100 mg/L the effusion was an exudate, whereas 81 % of patients with C-reactive protein above 170 mg/L had an empyema, p < 0.05. The patients who had an exudate needed lower doses of fibrinolytics than those who had an empyema (1.6 vs. 4.5, p < 0.05). The number of days having a chest tube or admitted in PICU was lower in patients with exudate (3 days each) than those with empyema (7 and 9 days respectively) (p < 0.05).


CONCLUSIONS
An increase in the number of complicated pneumonias is observed amongst children in our country, S. pneumoniae being the main aetiology. Using laboratory techniques such as C-reactive protein can help to distinguish between complicated and uncomplicated pneumonia. Pleural effusion characteristics seem to have an influence on the need for fibrinolytic and the length of chest tube treatment.
Espínola Docio
B
B
Unidad de Cuidados Intensivos Pediátricos, Hospital del Niño Jesús, Madrid, España. blaespdo@yahoo.es
Casado Flores
J
J
de la Calle Cabrera
T
T
López Guinea
A
A
Serrano González
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D018410:Pneumonia, Bacterial / Q000150:complications*; D012189:Retrospective Studies