The Clinical and Bacteriological Profile of Children with Empyema in a Tertiary Hospital

Abstract

Background: Empyema thoracis is a condition in which pus and fluid from infected tissue collects in the pleural cavity. Childhood empyema is an important complication of bacterial pneumonia. The incidence of empyema is increasing worldwide. Despite being recognized since the ancient times, the appropriate management of paediatric empyema thoracis remains controversial. Aims & objectives: 50 patients were included in the age group of less than 12 years with the diagnosis of empyema. All the patients were analysed for the clinical course of the disease, radiological investigations, pleural fluid biochemical and microbiological parameters, and various treatment options. Short term follow up was done for complications and sequelae. Subjects and Methods: 64% of the children were under 4 years of age. Males outnumbered females with a ratio of 1.17:1. 74% of the cases were recorded during spring and early summer. 64% of the cases belonged to lower socioeconomic strata. Fever, cough and hurried respiration were the predominant symptoms and the duration of illness of 80% of the cases was 7 14 days. 64% of our patients had received antibiotics prior to admission. Pneumonia predisposed to empyema in 48% of the cases. 56% of the cases had protein energy malnutrition and 2% were severely malnourished. Left sided empyemas (54%) were more frequent than the right (46%). 46% of the patients had culture positivity on pleural fluid. The commonest organism isolated was staphylococcus aureus (18%). Conclusion: Management of primary empyema continues to be controversial in terms of duration of antibiotic therapy and the indications for and timing of surgery.