title: Empyema thoracis in children: Still a challenge in developing countries.
abstract: BACKGROUND
  To evaluate the effectiveness of surgical intervention in managing empyema thoracis in children.
  
  
  METHODS
  A total of 70 patients aged 1-14 years diagnosed to have empyema thoracis and who underwent tube thoracostomy from January 2010 to December 2013 were studied. All patients of which 12 patients needed decortication.
  
  
  RESULTS
  The mean age of the study group was 5.44 years and 48.6% were male and 51.4% were female. The most common symptoms at admission were fever (90%), dyspnoea (73%), cough (70%) and chest pain (23%). Pleural fluid cultures were sterile in 60% of patients. The most frequently identified micro-organisms was Staphylococcus aureus (34.2%). Treatment with chest tube drainage was successful in 55 (78.6%) patients. Three patients got expired. Twelve patients had decortications, all of which were successful. The lung re-expansion time was 8.00 ± 1.68 days (range: 5-13 days) in those patients in whom chest tube drainage was successful, whereas it was 7.50 ± 2.623 days (range: 4-14 days) in patients in whom decortication was done. The post-procedure stay was 10.00 ± 1.809 days (range: 7-15 days) in patients with successful chest tube drainage and 9.5 ± 2.902 days (range: 6-17 days) in case of decortication cases.
  
  
  CONCLUSIONS
  Tube thoracostomy should be done in all cases of empyema thoracis regardless of stage, as this leads to reduction in septic load. Decision of decortication should be taken without any delay.
authors.affiliation: Department of Surgery, G.G.G.S. Medical College, Faridkot, Punjab, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Goyal
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.forename: Monica
authors.initials: M
authors.lastname: Gupta
authors.forename: Harinder Pal Singh
authors.initials: HP
authors.lastname: Sandhu
authors.forename: Shashikant
authors.initials: S
authors.lastname: Dhir
mesh_terms: D000293:Adolescent; D015505:Chest Tubes; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004322:Drainage / Q000379:methods*; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012424:Rural Population; D013907:Thoracostomy / Q000295:instrumentation*