OBJECTIVE: Pediatric empyema is increasing in incidence and continues to be a source of morbidity in children. Our objective was to determine the risk factors, clinical characteristics, distribution of the pathogens, and outcome of pediatric empyema in 2 Israeli pediatric medical centers. METHODS: This was a retrospective case-control study on children aged 2 months to 18 years hospitalized with community-acquired pneumonia (CAP) in the pre-Prevnar era (2000-2009). Demographic data, presenting symptoms, physical examination findings, imaging studies, laboratory results, hospital course, medical treatment, and surgical interventions were reviewed from medical records and computerized microbiology databases. RESULTS: One hundred ninety-one children comprised of 47 (24.9%) with parapneumonic empyema and 144(75.4%) without empyema. The symptoms and course of the children with empyema were substantially worse compared with patients without empyema. The most prevalent pathogen was Streptococcus pneumonia. The most common pneumococcal serotype was serotype 5, and 86% of the recovered S. pneumoniae were susceptible to penicillin. Children with empyema most commonly presented with prolonged fever, dyspnea (51%), and chest pain (17%). Forty-five children with empyema (98%) required a chest tube, fibrinolysis, or decortication with video-assisted thoracoscopy (VATS). Hospitalization stay was similar for children with empyema who underwent VATS and those who were treated conventionally. CONCLUSIONS: The most prevalent pathogen in children with CAP with and without empyema is S. pneumoniae. Children with empyema experience significantly more morbidity than did patients with CAP alone. In our experience, VATS apparently does not shorten the duration of hospitalization compared with conventional treatment. Immunization may affect the incidence of pediatric empyema and should be studied prospectively.
OBJECTIVE:Pediatric empyema is increasing in incidence and continues to be a source of morbidity in children. Our objective was to determine the risk factors, clinical characteristics, distribution of the pathogens, and outcome of pediatric empyema in 2 Israeli pediatric medical centers. METHODS: This was a retrospective case-control study on children aged 2 months to 18 years hospitalized with community-acquired pneumonia (CAP) in the pre-Prevnar era (2000-2009). Demographic data, presenting symptoms, physical examination findings, imaging studies, laboratory results, hospital course, medical treatment, and surgical interventions were reviewed from medical records and computerized microbiology databases. RESULTS: One hundred ninety-one children comprised of 47 (24.9%) with parapneumonic empyema and 144(75.4%) without empyema. The symptoms and course of the children with empyema were substantially worse compared with patients without empyema. The most prevalent pathogen was Streptococcus pneumonia. The most common pneumococcal serotype was serotype 5, and 86% of the recovered S. pneumoniae were susceptible to penicillin. Children with empyema most commonly presented with prolonged fever, dyspnea (51%), and chest pain (17%). Forty-five children with empyema (98%) required a chest tube, fibrinolysis, or decortication with video-assisted thoracoscopy (VATS). Hospitalization stay was similar for children with empyema who underwent VATS and those who were treated conventionally. CONCLUSIONS: The most prevalent pathogen in children with CAP with and without empyema is S. pneumoniae. Children with empyema experience significantly more morbidity than did patients with CAP alone. In our experience, VATS apparently does not shorten the duration of hospitalization compared with conventional treatment. Immunization may affect the incidence of pediatric empyema and should be studied prospectively.
Authors: Marijke Proesmans; Brenda Gijsens; Patricia Van de Wijdeven; Herbert De Caluwe; Jan Verhaegen; Katrien Lagrou; Ellen Van Even; Francois Vermeulen; Kris De Boeck Journal: Eur J Pediatr Date: 2014-05-17 Impact factor: 3.183
Authors: Florian J Segerer; Karin Seeger; Anna Maier; Christine Hagemann; Christoph Schoen; Mark van der Linden; Andrea Streng; Markus A Rose; Johannes G Liese Journal: Pediatr Pulmonol Date: 2016-09-20
Authors: Rabab Rashwan; Julius F Varano Della Vergiliana; Sally M Lansley; Hui Min Cheah; Natalia Popowicz; James C Paton; Grant W Waterer; Tiffany Townsend; Ian Kay; Jeremy S Brown; Y C Gary Lee Journal: PLoS One Date: 2018-07-30 Impact factor: 3.240
Authors: Elsa L Vazquez Melendez; John J Farrell; Andrea M Hujer; Kristin S Lowery; Rangarajan Sampath; Robert A Bonomo Journal: BMC Anesthesiol Date: 2014-11-22 Impact factor: 2.217