Clinical profile and outcome of children with parapneumonic effusion
- Author:
Grace Devota Gomez-Go
1
;
Ma. Liza Gonzales
1
;
Anna Ong-Lim
1
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Child; Child Preschool; Infant; Infant Newborn; PNEUMONIA; EMPYEMA; PLEURAL EFFUSION
- From: Pediatric Infectious Disease Society of the Philippines Journal 2012;13(1):15-28
- CountryPhilippines
- Language:English
- Abstract: Parapneumonic effusions frequently occur as complications of pneumonia. Data from developing countries is limited. The purpose of this paper is to review the epidemiological and clinical profile of parapneumonic effusions among children admitted in a tertiary government hospital. Methodology: Medical records of 72 children diagnosed with parapneumonic effusions from 2005-to-2009 were obtained. Demography, clinical presentations, diagnostics, treatment modalities, outcomes, etiology and antibiotic susceptibilities were analyzed using descriptive statistics. Comparison of purulent effusion and empyema was done using parametric or non-parametric statistics, accordingly. Results: There were 106 children discharged with a diagnosis of parapneumonic effusion. Of the 96 medical records available, 72 patients fulfilled the criteria for parapneumonic effusions. Only 53 patients submitted pleural fluid for analysis: 29 cases were empyema, while 24 cases were purulent effusion; mean age was 9.66 years. Fever (90.28%), cough (69.44%), and dyspnea (66.67%) were the most common clinical presentations. Forty-four patients underwent thoracentesis while 37 children had closed-tube thoracostomy. Methicillin-resistant Staphylococcus aureus(MRSA) was the most commonly isolated organism from the pleural fluid cultures (9.26%) and blood cultures (6.25%). Patients with purulent effusion were treated with a combination of antibiotics and anti-TB meds (75%).Majority of patients with empyema were treated with antibiotics alone (79.31%). Earlier improvement and shorter hospital stay were observed among patients with purulent effusion. Conclusion: Parapneumonic effusions occurred in 6.80% of hospitalized children with pneumonia; 54.72% of which were empyema and 45.28% were purulent effusion. MRSA was the most commonly isolated organism. Chest imaging, pleural fluid analysis and cultures, and blood cultures were important diagnostic procedures. The mainstays of treatment were medical, surgical or both, depending on the severity of effusion. Prompt diagnosis and management could account for favorable clinical outcomes.
- Full text:jo42_ja03.pdf
