title: Community-acquired pleuropneumonia in children: Bacteriological and therapeutic challenges.
abstract: Background Community-acquired pleuropneumonia (CPP) is a common complication of pneumonia in children. It is serious given its high morbidity and significant mortality. Aim To study clinical and paraclinical features of CPP in children and to establish a common therapeutic strategy. Methods Our retrospective study included patients who were hospitalized for CPP between 2004 and 2012. All data were collected from patients' medical files. Statistical analysis was made by Epi-Info 6. Results One hundred and sixty four patients were registered. The mean age was 32 months (15 days - 14.5 years). The hospital incidence of CPP doubled between 2004 and 2012. The symptomatology was dominated by fever (93.9%), cough (56.7%) and dyspnea (48.1%). The pleural effusion was frequently moderately abundant and loculated. Pleural sample, performed in 53.6% of cases, was the most beneficial bacteriological examination (p=10-6 ). The bacteriological confirmation was attained in 44.5% of cases with the predominance of Staphylococcus aureus (59%) followed by Streptococcus pneumoniae (26%). The S. aureus occurred basically in most young infants (p=0.04) and was responsible for the most severe cases (p=0.01). The CPP management included heterogeneous intravenous antibiotics associated with a pleural drainage in 40% of cases. The quarter of our patients were transferred to an intensive care unit. Six patients died. Conclusion The bacteriological confirmation is difficult. Pleural aspiration is the key tool. S. aureus is the first microorganism followed by S. pneumoniae. A therapeutic strategy is proposed based on large spectrum intravenous antibiotics. The pleural drainage indication is limited.
authors.forename: Samia
authors.initials: S
authors.lastname: Hamouda
authors.forename: Karima
authors.initials: K
authors.lastname: Chraiet
authors.forename: Fatma
authors.initials: F
authors.lastname: Khalsi
authors.forename: Imen
authors.initials: I
authors.lastname: Bel Hadj
authors.forename: Ines
authors.initials: I
authors.lastname: Brini
authors.forename: Hanen
authors.initials: H
authors.lastname: Smaoui
authors.forename: Sihem
authors.initials: S
authors.lastname: Barsaoui
authors.forename: Azza
authors.initials: A
authors.lastname: Samoud
authors.forename: Saida
authors.initials: S
authors.lastname: Ben Becher
authors.forename: Najla
authors.initials: N
authors.lastname: Ben Jaballah
authors.forename: Amel
authors.initials: A
authors.lastname: Kechrid
authors.forename: Faten
authors.initials: F
authors.lastname: Tinsa
authors.forename: Khadija
authors.initials: K
authors.lastname: Boussetta
mesh_terms: D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D004322:Drainage / Q000379:methods; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010996:Pleural Effusion / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D011001:Pleuropneumonia / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents