Source: Annual Congress 2002 - Empyema thoracis in children
Disease area: Respiratory infections

Abstract

Recently, use of more invasive treatment methods such as thoracoscopy or surgery rendered the treatment of childhood empyema controversial. In this study, we prospectively evaluated the outcome of conservative treatment in 25 children with empyema. Following recovery, all patients had immunological work-up with immunoglobulins, IgG subclasses and neutrophil functions. All patients received intravenous antibiotic treatment. Eighty seven percent of children (n=21) required chest tube drainage. The responsible organism was identified in only five children (25 %), this was thought to be secondary to previous antibiotic usage. Fibrinolytic treatment was used for five patients (25 %) who had incomplete clinical and radiological response to antibiotics and chest tube drainage. None of the children required thoracoscopy or open surgery. All children had complete resolution of their chest X-rays after 36,7±]11.6 (12-60) days. Underlying immunological defect (IgG subclass deficiency) was identified in four patients. Therefore, we conclude that before any invasive approaches, conservative treatment including antibiotic treatment and chest tube drainage should be considered in children with empyema. We also suggest that all patients who present with empyema should be screened for immunological abnormalities.

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Citations should be made in the following way:
S. Uyan, F. Karakoc, R. Hamutcu, B. Karadag, G. Kiyan, E. Dagli (Istanbul, Turkey). Empyema in children: conservative treatment and immunologic status. Eur Respir J 2002; 20: Suppl. 38, 3691

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