Analysis of the concise etiology of pleural effusion in 3707 pediatric patients in a single clinical center

Abstract

Purpose: To summarize the concise etiology of pleural effusion in 3707 patients over a period of 13 years at the Children’s Hospital of Chongqing Medical University. Methods: A total of 3707 patients with pleural effusion were included from January 2007 to December 2019 at our hospital. According to etiology, pleural effusion was divided into infectious pleural effusion and noninfectious pleural effusion. The infection factors were further subdivided as being caused by tuberculous, paragonimiasis, parapneumonic factors (including multiple bacterias, multiple viruses, mycoplasma, chlamydia, chlamydia, fungus and fever, blood routine examination shows increased white blood cells and neutrophils). The noninfectious factors were further subdivided into neoplastic, trauma, other causes. They were also divided into the infants and young children group (3 y and below), the preschool group (3–6 y) and the school-age group (above 6 y) depending on age. Results: Among the 3707 children, there were 2925 (78.9%) patients with infectious pleural effusions, and 782 (21.1%) patients with noninfectious pleural effusions. The incidence of infectious pleural effusions caused by parapneumonic factors decreased significantly with increasing age; however, parapneumonic factors remained the primary etiology of infectious pleural effusion in each group. The incidence of infectious pleural effusions caused by tuberculosis and paragonimiasis increased significantly with increasing of age. Tumor was the primary cause of noninfectious pleural effusion. The incidence of noninfectious pleural effusion caused by tumor and other causes increased significantly with increasing age. The incidence of noninfectious pleural effusion caused by trauma in the preschool group was significantly greater than that of the infants and young children group and school-age group. The number of noninfectious pleural effusion caused by other causes in the school-age group were significantly greater than those of in the infants and young children group and preschool group. Conclusion: In our center, pediatric pleural effusion was primarily caused by infections. parapneumonic factors were the primary causes of infectious pleural effusions. The proportion of noninfective pleural effusions in the etiology of pleural effusion in children was small; however, some were difficult to treat, requiring long-term treatment and possibly poor prognosis. Therefore, multidisciplinary treatment should be combined.