Empyema and bacteremic pneumococcal pneumonia in children under five years of age

Cardoso, Maria Regina Alves; Nascimento‐Carvalho, Cristiana M.; Ferrero, Fernando; Berezin, Eitan Naaman; Ruvinsky, Raúl; Sant’Anna, Clemax Couto; Brandileone, Maria Cristina de Cunto; March, Maria de Fátima Bazhuni Pombo; Maggi, Ruben Schindler; Feris-Iglesias, Jesús; Benguigui, Yehuda; Camargos, Paulo Augusto Moreira

doi:10.1590/s1806-37132014000100010

Cited by 4 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both the long duration of hospital stay (LOS) and the fact that 58% of children with PPE/PE required treatment in an intensive care unit confirm the severity of this disease. The median LOS of 17 (IQR [13][14][15][16][17][18][19][20][21][22][23][24] days is comparable to values reported from studies in Spain (17 days) 16 and Israel (15 days). 17 However, a number of other studies have reported shorter LOS for children with PPE/PE: A study in Brazil reported a median LOS of 11 days in 102 children; however, children with very severe pneumonia and signs of bacteremia were excluded.…”

Section: Discussionsupporting

confidence: 63%

“…The median LOS of 17 (IQR 13–24) days is comparable to values reported from studies in Spain (17 days) and Israel (15 days) . However, a number of other studies have reported shorter LOS for children with PPE/PE: A study in Brazil reported a median LOS of 11 days in 102 children; however, children with very severe pneumonia and signs of bacteremia were excluded . In a small prospective study with 18 patients by Kurt et al, children treated with pleural draining catheter and subsequently receiving intrapleural fibrinolytic therapy in their further course of disease had a mean LOS of 13 days compared to 6 days for children following initial VATS; the fact that the treatment was carried out in a highly specialized center may, together with the specific characteristics of the US health care system, offer a possible explanation for the considerably shorter LOS observed in that study.…”

Section: Discussionmentioning

confidence: 99%

“…The median total LOS of all 645 children with PPE/PE was 17 days (IQR [13][14][15][16][17][18][19][20][21][22][23][24]. Of the 645 children with PPE/ PE, 375 (58%) required treatment in an intensive care unit for a median of 7 days (IQR 4-14) and 124 children (19%) needed mechanical ventilation for a median of 5 days (IQR 2-10).…”

Section: Los and Clinical Outcomementioning

confidence: 99%

See 2 more Smart Citations

Therapy of 645 children with parapneumonic effusion and empyema—A German nationwide surveillance study

Segerer¹,

Seeger²,

Maier³

et al. 2016

Pediatric Pulmonology

View full text Add to dashboard Cite

SummaryObjective: To evaluate the initial management of pediatric parapneumonic effusion or pleural empyema (PPE/PE) with regard to length of hospital stay (LOS). Methods: Collection of pediatric PPE/PE cases using a nationwide surveillance system (ESPED) from 10/2010 to 06/2013, in all German pediatric hospitals. Inclusion of PPE/PE patients <18 years of age requiring drainage or with a PPE/PE persistence >7 days. Staging of PPE/PE based on reported pleural sonographic imaging. Comparison of LOS after diagnosis between children treated with different forms of initial invasive procedures performed ≤3 days after PPE/PE diagnosis: pleural puncture, draining catheter, intrapleural fibrinolytic therapy, surgical procedures. Results: Inclusion of 645 children (median age 5 years); median total LOS 17 days. Initial therapy was non‐invasive in 282 (45%) cases and invasive in 347 (55%) cases (pleural puncture: 62 [10%], draining catheter: 153 [24%], intrapleural fibrinolytic therapy: 89 [14%], surgical procedures: 43 [7%]). LOS after diagnosis did not differ between children initially treated with different invasive procedures. Results remained unchanged when controlling for sonographic stage, preexisting diseases, and other potential confounders. Repeated use of invasive procedures was observed more often after initial non‐invasive treatment or pleural puncture alone than after initial pleural drainage, intrapleural fibrinolytic therapy or surgery. Conclusions: Initial treatment with intrapleural fibrinolytic therapy or surgical procedures did not result in shorter LOS than initial pleural puncture alone. Larger prospective studies are required to investigate which children benefit significantly from more intensive forms of initial invasive treatment. Pediatr Pulmonol. 2017;52:540–547. © 2016 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc.

show abstract

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Los and Clinical Outcomementioning

confidence: 99%

See 1 more Smart Citation

Therapy of 645 children with parapneumonic effusion and empyema—A German nationwide surveillance study

Segerer¹,

Seeger²,

Maier³

et al. 2016

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Entre los gérmenes productores de neumonías con derrame, el más frecuente en menores de 5 años sin factores de riesgo es el S. pneumoniae. 119 Con mucha menor prevalencia, se encuentra el S. aureus. Tal como se refirió en el apartado "Neumonía", la incorporación de la vacunación contra H. influenzae b al calendario oficial ha hecho que la prevalencia de microorganismos haya disminuido de manera muy significativa, y probablemente la vacuna antineumocócica también tenga influencia en la epidemiología de este germen en SPP en un futuro cercano.…”

Section: Epidemiologíaunclassified

Recomendaciones para el manejo de las infecciones respiratorias agudas bajas en menores de 2 años. Actualización 2021

2021

Arch Argent Pediat

View full text Add to dashboard Cite

show abstract

“…Pyothorax is a purulent infection in which pathogenic bacteria invade the pleura or lymphoid tissue directly or indirectly, and the purulent exudate accumulated in the pleural cavity [4].There are many reports that the incidence of empyema in children is increasing [5][6] .Empyema mostly develops from pneumonia.The pathological process of pleural effusion can be divided into three stages: exudative stage, brous purulent stage and organizing stage.The mortality of empyema can be as high as 15% ~ 20% [7] .There is no uniform standard for the treatment of pleural effusion, and each stage of treatment focuses on different, which requires our clinicians to identify empyema in time, and strive to give timely and effective treatment in the shortest time.…”

Section: Discussmentioning

confidence: 99%

Risk Factors of Empyema in Children in Suzhou, China

Yin-yin

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Respiratory tract infection is the most common disease in children, and pneumonia is the main disease. Pleural effusion is a common complication of pneumonia. Data show that up to 57% of hospitalized pneumonia patients have pleural effusion[1]. The parapneumonic pleural effusion (PPE) was divided into three categories: uncomplicated parapneumonic effusion (uppe), complex parapneumonic pleural effusion (CPPE) and parapneumonic empyema (PE)[2].Empyema is a kind of respiratory tract infectious disease with dangerous condition, rapid development and high mortality. Improper treatment can also develop into chronic empyema, and severe complications such as bronchopleural fistula, lung abscess and heart failure may occur. Therefore, timely identification of empyema, active and effective treatment and necessary invasive operation are very important to slow down the disease and reduce the mortality rate.Methods To analyzed the data of children with parapneumonic pleural effusion who were hospitalized in respiratory department of our hospital from January 2010 to December 2018. According to the results of pleural effusion, according to the light classification standard, they were divided into uncomplex parapneumonic effusion (UPPE group) and empyema group (PE group),Logistic regression was used to analyze the risk factors of empyema in children, and receiver operating characteristic (ROC) curve was drawn.Results A total of 63 children were included in the study, including 20 cases in UPPE group and 43 cases in PE group. Univariate analysis showed that children in PE group were younger than those in UPPE group [2.8 (1.1,5.83) vs. 6.54 (2.94,9.0), P < 0.05], clinical manifestations were more prone to shortness of breath (60.46% vs. 8.961, P < 0.05), wheezing (32.55% vs. 5%, P < 0.05), and C-reactive protein (CRP) in laboratory examination was higher [114.76 (54.19160.94) vs. 49.79 (23.68, 84.48), P < 0.05];In cellular immunity, CD3 + was lower (55.31 ± 14.15 vs. 65.76 ± 11.43, P < 0.05), CD3 + CD4 + was lower (27.32 ± 9.58 vs. 34.77 ± 7.99, P < 0.05), CD3-CD19 + was higher (31.61 ± 13.24 vs. 21.98 ± 9.63, P < 0.05), and more susceptible to bacterial infection (44.18% vs. 10%, P < 0.01).Multivariate logistic regression analysis showed that shortness of breath (or = 5.099,95% CI: 1.309-19.866) and elevated CRP (or = 1.013,95% CI: 1.001-1.026) were independent risk factors for empyema. The area under the ROC curve (AUC) of logistic regression model was 0.707 and 0.716, respectively, with moderate diagnostic accuracy.Conclusions The children with parapneumonic pleural effusion with shortness of breath and CRP > 89.41mg/l should be aware of empyema.

show abstract

Empyema and bacteremic pneumococcal pneumonia in children under five years of age

Cited by 4 publications

References 6 publications

Therapy of 645 children with parapneumonic effusion and empyema—A German nationwide surveillance study

Therapy of 645 children with parapneumonic effusion and empyema—A German nationwide surveillance study

Recomendaciones para el manejo de las infecciones respiratorias agudas bajas en menores de 2 años. Actualización 2021

Risk Factors of Empyema in Children in Suzhou, China

Contact Info

Product

Resources

About