ORIGINAL ARTICLES  THORACIC PAPERS 

The Journal of Cardiovascular Surgery 1998 February;39(1):113-6

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Empyema in children

Sarihan H., Cay A., Aynaci M.*, Akyazici R., Baki A.*

From the Department of Pediatric Surgery and *Pediatrics, Karadeniz Technical University Faculty of Medicine, Turkey

Empyemas devel­op fol­low­ing bac­te­ri­al pneu­mon­ias, tho­rac­ic trau­ma ­and sur­gery ­which ­are ­still ­among ­the com­mon dis­eas­es, caus­ing ill­ness ­and ­death through­out ­the devel­op­ing ­world. With ­the ­advent of ­potent anti­bi­o­tics ­the mor­tal­ity of empye­ma ­has ­been dras­ti­cal­ly ­reduced. In ­this ­study 52 ­patients (29 ­boys ­and 23 ­girls) ­with thor­a­cic empye­ma ­were eval­u­at­ed ret­ro­spec­tive­ly. In ­this ­series ­the caus­es of empye­ma ­were postp­neu­mon­ic in 50 ­patients, esoph­a­geal anos­to­mot­ic ­leak in ­one ­patient, ­and tho­rac­ic trau­ma in ­one ­patient. The diag­no­sis ­was sus­pect­ed clin­i­cal­ly ­and by ­the find­ing of a pleu­ral effu­sion on ­chest roent­ge­no­gram. Definitive diag­no­sis ­was con­firmed by pleu­ral aspi­ra­tion ­which ­pus ­was ­obtained. Responsible organ­isms includ­ed; Staphylococcus aure­us, Streptococcus pneu­mo­nia, Haemophilus influen­za, pseu­do­mo­nas, ­and Klebsiella. The ­most com­mon is Staphylococcus aure­us. The ­patients ­were treat­ed in var­i­ous ­ways; 14 ­patients ­were treat­ed ­with anti­bi­o­tics ­and thor­a­cen­te­sis, 38 ­patients ­were treat­ed ­with a ­closed ­tube thor­a­cos­to­my. Eight of 38 ­patients ­had ­the ­chest ­tube con­vert­ed to an ­open empye­ma ­tubes ­for ­long ­term man­age­ment. Fourteen of 38 ­patients devel­oped ­abcess for­ma­tion. Nine of 14 ­patients ­were treat­ed ­with com­put­ed tomog­ra­phy guid­ed cath­e­ter place­ment, ­five ­patients encoun­tered thor­a­cot­o­my ­and dec­or­ti­ca­tion. In ­this arti­cle, appro­pri­ate treat­ment ­and ­result of ­long-­term fol­low-up of empye­ma ­were eval­u­at­ed.