Neonatal empyema thoracis

Abstract

Empyema thoracis, a serious complication of pneumonia, fortunately remains a less common cause of respiratory distress in neonates. Only 14 cases of neonatal empyema thoracis have been described in the world literature. The condition is characterized by its rarity, inability to identify any consistent predisposing factors, uncertain pathogenesis, rapid course, lack of consensus on management and a high mortality. We describe here two cases of empyema aged 6 and 8 days caused by E. Coli and Klebsiella respectively. Out of them one survived. A brief review of literature follows the above account.

Pleural empyema due to group A beta-hemolytic streptococci in a newborn: case report

“…However, in neonates, empyema is a potentially fatal condition if not recognized and treated early (3). By this case, we would like to express that GAS may cause pneumonia complicated with pleural empyema in the neonatal period.…”

“…Chest X-ray showed shift of the mediastinum to the right, atelectasis and pleural effusion on the left side ( Figure 1). Laboratory investigation revealed a hemoglobin of 15.5 g/dL, a hematocrit of 52%, a leukocyte count of 12.900/mm 3 . Serum C-reactive protein (CRP) level was high (286 mg/L, N: < 10 mg/L).…”

“…Laboratory analyses showed leucocytosis (21.500/mm 3 hilia (76%), and increase in serum CRP (138 mg/L). Large left sided pleural effusion was noted on the control chest X-ray.…”

“…There are only a few reports on pleural empyema due to GAS in newborn infants (1,3). Therefore, we want to report a case of early onset neonatal pneumonia caused by GAS and complicated with pleural empyema.…”

Klebsiella pneumoniae: caught on film

“…The most commonly described organisms are Staphylococcus aureus , β haemolytic streptococci and Escherichia coli ,1 reflecting the common causes of neonatal sepsis. Only three cases of neonatal empyema due to K pneumoniae have previously been described in the medical literature 1 – 3…”