Parapneumonic pleural effusion and empyema in children. Description of 23 cases

Abstract

It was realized a descriptive retrospective study to 23 peneumonic patients with effusion. Issues: 34.7% were younger than 2 years old. 56.6% were female. Symptons and signs were: fever (100%), dyspnea (82.6%), cough (82%), thoracic pain (43.4%), refered pain (13.4%), hypoventilation (87%), bronquial blowing (34.7%) andcrepitates (30.4%). Radiographies showed minor efussion of 1/3 of hemi-thorax in 56.5%, half efussion in 13% and total efussion in 26%. 43.7% of ecographies showed sepmms, partition walls and detritus. Leucocytes, sedimentation and PCR were pretty high in everyone. Pleural liquid showed: pus (60%), DHL higher than 1000U (58%) and glucose lower than40 (46.1%). Latex test was positive in 6 patients: 4 for pneumococo, 1 for pneumococo and meningococo and 1 for meningococo. 9 cultives were positives of PL.: S aureus 31.6%, H influenzae 10.5% and S. Pneumoniae 5.2%. Sensitivity was 3 to penicilline of 4 S. pneumniae and one had half resistence, sensitivity o cefotaxime and cloramfenicol. Everyone of S. Aureus were sensitivity to oxaciline. One was sensitivity to ampicilin and the other one resistent to it but sensitivity to cefotaxime and cloramfenicol of the 2 H. Influenzae. 16 patients had thoracic catheter during 16 days. Six patients requiered decortication. Conclussions: Children younger than 2 years old are the most affected. Ecography is very important for the therapeutic orientation. Latex it is a useful prove for diagnosis. S. Aureus and H. Influenzae are the most often genns. Oxaciline and third generation cephalosporine are the antibiotics to begin therapy.