title: Clinical characteristics of 323 children with parapneumonic pleural effusion and pleural empyema due to community acquired pneumonia.
abstract: BACKGROUND
  An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) in children has been found in several studies published in the last decades. The aim of the study was to evaluate the incidence, etiology, clinical features, treatment strategies and outcomes of PPE/PE in children treated in a referral pulmonary center in central Poland.
  
  
  METHODS
  We performed a retrospective analysis of clinical, radiological and laboratory data of all children aged between 1 month and 18 years with PPE/PE due to community acquired pneumonia (CAP) between January 2002 and December 2013.
  
  
  RESULTS
  One thousand nine hundred and thirty three children with CAP were hospitalized between 2002 and 2013. Parapneumonic effusion or PE was diagnosed in 323 children (16.7%). The proportion of children with CAP related PPE/PE increased from 5.4% in 2002 to 18.8% in 2013. Streptococcus pneumoniae was the most common causative microorganism, responsible for 66.7% cases of known etiology. All children were treated with antibiotics and in 22.6%, and 74.3% of the patients therapeutic thoracentesis, pleural drainage with or without intrapleural fibrinolysis was performed, respectively. Approximately 3% of patients required surgical intervention.
  
  
  CONCLUSIONS
  A significant increase in the incidence of PPE/PE in children with CAP treated in our institution in the last twelve years was found. S. pneumoniae was the most common causative microorganism. Antibiotic therapy with chest drain insertion ± intrapleural fibrinolysis is an effective treatment of PPE/PE and surgical intervention is seldom necessary. With proper management, the overall prognosis in children with CAP related PPE/PE is good.
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland. Electronic address: katarzynakrenke@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Krenke
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Urbankowska
authors.affiliation: Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbankowski
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Lange
authors.affiliation: Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Kulus
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology; D004322:Drainage; D016724:Empyema, Pleural / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology; D018410:Pneumonia, Bacterial / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Children; Pleural drainage; Pleural effusion; Pneumonia; Streptococcus pneumoniae