The Changing Face of Pleural Empyemas in Children: Epidemiology and Management

Schultz, Karen D.; Fan, Leland L.; Pinsky, Jay; Ochoa, Lyssa N.; Smith, E. O’Brian; Kaplan, Sheldon L.; Brandt, Mary L.

doi:10.1542/peds.113.6.1735

Cited by 207 publications

(143 citation statements)

References 26 publications

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“…Bacteria from pleural fluid was isolated in 35% of cases in our study and when compared with various other studies it was found that Lochindarat et al, found 18.3% pleural fluid culture positive cases, Karen D. Schultz et al, in 2004 andGhosal, et al, in 1996 observed an isolation rate of 32 % and 26.5% respectively (24,25,26 In the present study out of 113 sputum and pleural fluid samples processed, 91.15% showed no fungal growth.…”

Section: Chun-yi-lee Et Al Observed Thatsupporting

confidence: 62%

Microbiological Profile of Childhood Pneumonias in Hyderabad, India

Haritha¹,

Shailaja²

2017

Int.J.Curr.Microbiol.App.Sci

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Section: Chun-yi-lee Et Al Observed Thatsupporting

confidence: 62%

Microbiological Profile of Childhood Pneumonias in Hyderabad, India

Haritha¹,

Shailaja²

2017

Int.J.Curr.Microbiol.App.Sci

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“…12 Immunisation plays a major role in reduction of empyema and its complications compared to study done by Karen D Schultz et al where staphylococcus was the most predominant organism and pneumoccal vaccination heled in preventing complications. 13 Chest X-ray helps in identification of significant amount of pleural fluid. Ultrasonography can be used to localize fluid for a thoracentesis.…”

Section: Resultsmentioning

confidence: 99%

Risk factors associated with adverse outcome in empyema thoracis children aged 1 month-12 years in a tertiary care centre: a nested case control study

Arunagirinathan

Stalin

Eswar³

2017

Int J Contemp Pediatr

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Background: Empyema thoracis (ET) is serious complication of pneumonia in children, treatment outcome depends upon many risk factors. Empyema thoracis is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, ET remains associated with high morbidity worldwide. This study was undertaken to identify risk factors associated with poor outcome and to describe etiological agents.Methods: This nested case control study was conducted at Institute of Child Health and Hospital for Children, Egmore, and Chennai from January 2011 to October 2012 in age group from 1 month to 12 years attending with clinical/radiological evidence of empyema. Cases children with complications and controls without complications. Basic investigations, ultrasonogram chest, pleural fluid gram stain/ culture and blood culture done. Antibiotics started empirically and changed based on culture and sensitivity. Intercostal drainage (ICD) was inserted with an underwater seal. Demographic data and other variables analysed were haemoglobin, persistent positive CRP, serum albumin level, pleural fluid gram stain, culture and sensitivity, imaging like ultra-sonogram, CECT, X-ray chest after ICD insertion.Results: Of 90 empyema cases, 26 recovered without complication, 56 recovered with complication, 8 died. Logistic regression uses to find association between variables and complications. Risk factors significantly associated with complications were persistent positive CRP, pleural fluid gram stain, imaging ultra-sonogram chest showing loculations, CECT scan showing pleural thickening and X-ray chest after ICD insertion.Conclusions: Independent risk factors associated with complications were X-ray chest after ICD insertion showing non-resolution, ultrasonogram revealing loculations and septations. Early diagnosis, appropriate antibiotics and timely intervention helps in reduction of empyema and complications.

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“…The most common manifestation of CA-MRSA infection is SSTI (38). However, there are accumulating reports of severe disease, including sepsis (39), necrotizing fasciitis (40), purpura fulminans (41), toxic shock syndrome (42,43), necrotizing pneumonia (44,45) and empyema (46,47), caused by CA-MRSA. These severe presentations may occur in otherwise healthy children and young adults.…”

Section: Definition Limitationsmentioning

confidence: 99%

“…• Suspect CA-MRSA in severe infections compatible with S aureus (eg, sepsis [39], necrotizing fasciitis [40], necrotizing pneumonia [44,45] and empyema [46,47]). …”

Section: When To Suspect Ca-mrsa Recommendationsmentioning

confidence: 99%