Abstract

Parapneumonic effusion and subsequent empyema are known complications of bacterial pneumonia. It is seen in approximately 2 to 12 percent of children with pneumonia and up to 28 percent of those requiring hospitalization as pneumonia [1,2]. Recurrent empyema is recurrence of empyema after its apparent healing. The incidence of recurrent empyema in children is 8.9% of empyema cases. Possible causes of recurrent empyema are recurrent pneumonia, chest surgery, immunodeficiency and chronic lung diseases. Surgical treatment of empyema is preferred by many experts more than conservative treatment alone. Recurrent empyema often needs surgical interventions to treat the cause and complications to achieve complete recovery [1,2]. We present a case of recurrent empyema in a previously healthy 7-year-old boy who had no underlying etiology inspite of extensive investigation and who recovered completely without open thoracotomy or video-assisted thoracoscopic surgery (VATS).

Keywords:Recurrent Empyema; Children; Pleural Effusion; Bacterial Pneumonia

References

1. Byington CL., et al. “An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological associations”. Clinical Infectious Diseases 34 (2002): 434.
2. BP Kuti and OA Oyelami. “Risk factors for parapneumonic effusions among children admitted with community-acquired pneumonia at a tertiary hospital in south-west Nigeria”. The African Journal of Respiratory Medicine 1 (2014).
3. AF Saleem., et al. “Empyema Thoracis in Children: Clinical Presentation, Management and Complications”. Journal of College of Physicians and Surgeons Pakistan 8 (2014): 573-576.
4. Narendra and Daizy. “Empyema Thoracis In Children: A Clinical Study”. Journal of Evolution of Medical and Dental Sciences 5 (2016).
5. IM Balfour-Lynn., et al. “BTS guidelines for the management of pleural infection in children”. Thorax11 (2005): i1-i21.
6. KR Shen., et al. “The American Association for Thoracic Surgery consensus guidelines for the management of empyema”. The Journal of Thoracic and Cardiovascular Surgery 6 (2017): e129-e146.
7. Wiese AD., et al. “Changes in empyema among U.S. children in the pneumococcal conjugate vaccine era”. Vaccine 34 (2016): 6243.
8. SK Angurana., et al. “Pediatric empyema thoracis: What has changed over a decade?” Journal of Tropical Pediatrics's 3 (2018): 231-239.
9. JE Heffner., et al. “Pleural fluid chemical analysis in parapneumonic effusions. A meta-analysis”. American Journal of Respiratory and Critical Care Medicine 6 (1995): 1700-1708.
10. RW Light., et al. “Parapneumonic effusions”. The American Journal of Medicine 4 (1980): 507-512.
11. Islam S., et al. “The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee”. Journal of Pediatric Surgery 47 (2012): 2101.
12. Yang PC., et al. “Value of sonography in determining the nature of pleural effusion: analysis of 320 cases”. American Journal of Roentgenology 159 (1992): 29.
13. Balfour-Lynn IM., et al. “BTS guidelines for the management of pleural infection in children”. Thorax1 (2005): i1.
14. AT Society. “Management of nontuberculous empyema”. The American Review of Respiratory Disease Returns 85 (1962): 935-936.
15. RE Strachan and A Jaffé. “Recommendations for managing paediatric empyema thoracis”. Medical Journal of Australia 2 (2011): 95.
16. PP España., et al. “A prediction rule to identify allocation of inpatient care in community-acquired pneumonia”. European Respiratory Journal 4 (2003): 695-701.

Citation

Citation: Gihad Alsaeed., et al. “Recurrent Empyema in a Healthy 7 Year Old Boy”. Acta Scientific Paediatrics 3.7 (2020): 54-60.

Copyright

Copyright: © 2020 Gihad Alsaeed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.