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<p>The optimal timing and mode of treatment of children with empyema thoracis remain controversial. In this study, we evaluated the treatment and outcome of the management of empyema thoracis in pediatric patients at a tertiary hospital. Hundred and five patients with diagnosed empyema thoracis, treated in the Surgery Department from January 2019 to December 2023, satisfying inclusion criteria were included in our study. All the patients were managed initially with tube thoracostomy (TT). Those not responding to TT were further managed with open thoracotomy (OT)/video-assisted thoracoscopic procedure (VATS). All patients were followed up with clinical examination and chest radiograph at 2&#xa0;weeks, 6&#xa0;weeks, 3&#xa0;months, and 6&#xa0;months after discharge. The mean age of cohort was 4.52&#xa0;years (45&#xa0;days–12&#xa0;years). Incidence was more commonly seen during hot and humid weather. <i>Staphylococcus aureus</i> was the most common isolated organism. Culture positivity was observed only in 13.33% of cases. Fever (90.47%), cough (80%), and breathlessness (36.19%) were the most common presenting symptoms. Pneumonia was the most common cause, which was seen in 92 patients (87.62%). All 105 patients received tube thoracostomy as primary management and was successful in 76% (80 patients); the remaining 25 cases required further surgical intervention. After surgery, the mean duration of chest tube drainage and total hospital stay was 6.5 and 21.95&#xa0;days respectively. Simple chest tube drainage is safe and effective in most cases. Cases non-responding to TT may benefit from early intervention, preferably within 1&#xa0;week.</p>

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A Study of 105 Cases of Empyema Thoracis in Pediatric Patients—Our Experience In Tertiary Care Institute

  • 期刊论文

  • 发表日期：

    2025年4月25日

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  • Sedengulie Nagi,
  • Loreno Enny,
  • Nilokali Chisi,
  • Kuotho Nyuwi,
  • Subhajeet Dey

摘要

The optimal timing and mode of treatment of children with empyema thoracis remain controversial. In this study, we evaluated the treatment and outcome of the management of empyema thoracis in pediatric patients at a tertiary hospital. Hundred and five patients with diagnosed empyema thoracis, treated in the Surgery Department from January 2019 to December 2023, satisfying inclusion criteria were included in our study. All the patients were managed initially with tube thoracostomy (TT). Those not responding to TT were further managed with open thoracotomy (OT)/video-assisted thoracoscopic procedure (VATS). All patients were followed up with clinical examination and chest radiograph at 2 weeks, 6 weeks, 3 months, and 6 months after discharge. The mean age of cohort was 4.52 years (45 days–12 years). Incidence was more commonly seen during hot and humid weather. Staphylococcus aureus was the most common isolated organism. Culture positivity was observed only in 13.33% of cases. Fever (90.47%), cough (80%), and breathlessness (36.19%) were the most common presenting symptoms. Pneumonia was the most common cause, which was seen in 92 patients (87.62%). All 105 patients received tube thoracostomy as primary management and was successful in 76% (80 patients); the remaining 25 cases required further surgical intervention. After surgery, the mean duration of chest tube drainage and total hospital stay was 6.5 and 21.95 days respectively. Simple chest tube drainage is safe and effective in most cases. Cases non-responding to TT may benefit from early intervention, preferably within 1 week.