Should Empyema with or without Necrotizing Pneumonia in Children Be Managed Differently?

Details

Serval ID
serval:BIB_6158D012DA0D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Should Empyema with or without Necrotizing Pneumonia in Children Be Managed Differently?
Journal
Health
Author(s)
Stelle Karine Anastaze, Mornand Anne, Bajwa Nadia, Vidal Isabelle, Anooshiravani Mehrak, Kanavaki Aikaterini, Argiroffo Constance Barazzone, Blanchon Sylvain
ISSN
1949-4998
1949-5005
Publication state
Published
Issued date
2017
Volume
09
Number
02
Pages
209-222
Language
english
Abstract
Background: Necrotizing pneumonia (NP) is an increasing lung infection mostly asso-ciated with pleural empyema.
Objectives: We aimed to compare children with empyema with and without concomi-tant NP, in terms of risk factors, management and outcome.
Methods: We retrospectively included children hospitalized between 2005-2014 with empyema to whom a computed tomography was perfomed. We recorded patient characteristics, clinical, biological (blood and pleural fluid) and radiological findings, medical and surgical treatments, and clinical, radiological and functional follow-up.
Results: 35 children with empyema were included, including 25 with a concomitant NP. Patients with or without NP were undistinguishable, in terms of characteristics, symptoms at admission or detected pathogens. Pleural leucocytes were significantly higher in the empyema group (p=0.0002) as pleural LDH (p=0.002), and pleural/blood LDH ratio (p=0.0005). Medical and surgical managements were similar between both groups. Complications occurred in 1/10 children with empyema alone (pneumotocele) and 5/25 with concomitant NP (bronchopleural fistula (n=3), lobectomy, pneumotho-rax). The hospital length of stay and delay for chest X-ray normalization were similar in both groups.
Conclusion: Except for minor biological parameters, the presence of concomitant NP in case of empyema does not change the presentation, clinical features, management and outcome, suggesting that the presence of additional NP to empyema should not be managed differently and that chest CT should probably not be routinely performed to confirm a suspected concomitant NP.
Open Access
Yes
Create date
15/05/2020 17:27
Last modification date
16/05/2020 6:26
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