Source: Annual Congress 2006 - Pneumonia and other invasive pulmonary infections in children
Disease area: Respiratory infections

Abstract

Medical records of 492 pediatric patients with pleural effusions admitted to Hacettepe University between 1975-2003 were reviewed. Number of admissions between 1975-1983, 1984-1993 and 1994-2003 were 164, 169 and 159, respectively. Age distribution of patients were as follows: 34.1% between 0-2 years, 23.8% between 3-5 years, 22.8% between 6-10 years and 19.3% over 10 years of age. Subtypes of effusions were parapneumonic in 381 (77.4%), tuberculous pleurisy in 52 (10.6%), malignant in 19 (3.9%), tuberculous pleurisy and empyema in 10 (2%), congestive heart failure in 7 (1.4%), chylothorax in 1 (0.2%) and undefined in 22 (4.5%). In 381 patients with parapneumonic pleural effusions, 61.7% had empyema, 10% had complicated parapneumonic effusion, 7.9% had noncomplicated parapneumonic effusions, whereas in 20.5% a subtype could not be identifed. Management options included pleural drainage and antibacterial therapy in 59.6%, antibacterial therapy after a diagnostic thoracentesis in 31.5%, surgical decortication in 8.1% and instillation of intrapleural fibrinolytic agents in 0.8%. A causative microorganism was not identified in 249 (65.4%) of patients, whereas S.aureus was detected in 57 (15%)patients, pneumococci in 27 (7.1%), H.influenzae in 4 (1%). Penicillin resistant pneumococcal strains were isolated in only three patients. Further analysis revealed decreasing frequencies of tuberculous pleurisy and decreasing number of patients undergoing surgical decortication, increasing detection of causative microorganisms and increasing identification of parapneumonic effusion subtypes, decreasing frequencies of S.aureus and increasing frequencies of S.pneumoniae and H.influenzae.

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E. G. Utine, U. Ozcelik, E. Yalcin, D. Dogru, N. Cobanoglu, S. Pekcan, N. Kiper, A. Gocmen (Ankara, Turkey). Pediatric pleural effusions: a retrospective review of 492 patients. Eur Respir J 2006; 28: Suppl. 50, 1791

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