Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children from a Tertiary Care Center in Eastern India

Abstract

Background Empyema thoracis is a complication of bacterial pneumonia, which can cause significant morbidity and mortality in children. Timely diagnosis and adequate treatment of pneumonia is essential. Objective To determine clinico-bacteriological profile of children admitted with empyema thoracis and to study their outcome and short-term follow-up. Materials and Methods This study was a prospective observational study, performed in age group of 1 month to 14 years admitted in a Tertiary Care Hospital of Odisha over a period of 3 years (March 2020 to February 2023). Results Of 95 patients, most (45) were of age from 1 to 5 years with a mean age of 68.46 ± 39.33 months and male to female ratio of 1.3:1. The peak of cases was seen during the month of March to July. Most common presentation was fever (99%) followed by cough (97%). On pleural fluid analysis organisms were isolated in 45 cases, staphylococcus aureus being commonest (21). Eighty children (84.5%) were treated with antibiotics and intercostal drainage tube, whereas 8 cases (8.5%) needed aspiration and antibiotics. Seven cases (7%) required surgical treatment in the form of decortication or thoracotomy and Video Assisted Thoracoscopic Surgery (VATS). Most common complication was pyopneumothorax, found in 34 cases (36%). Out of 95, 81 (85.3%) were cured, 3(3.2%) died and 4 (4.2%) left against medical advice. Four cases at 15 days follow-up and 2 cases at 2 months follow-up showed restrictive pattern of Pulmonary Function Test. Conclusion Empyema thoracis in children is a dreaded complication of pneumonia. Early diagnosis and effective treatment of pneumonia can decrease morbidity and mortality.

Keywords

• children
• empyema thoracis
• malnutrition
• pyopneumothorax
• staphylococcus aureus