Departments of Pediatrics, *Pediatric surgery, and #Radiodiagnosis, Maulana Azad Medical College and associated Hospitals, University of Delhi, New Delhi, India. Correspondence to: Dr GR Sethi, Director Professor, Department of Pediatrics, Maulana Azad Medical College, Delhi 110 002, India.
Indian Pediatr. 2013 Sep;50(9):879-82. doi: 10.1007/s13312-013-0232-8. Epub 2013 Apr 5.
This study prospectively evaluates clinical course of pyogenic empyema thoracis in 25 children (2 mo to 12 y) treated with injectable antibiotics and chest tube drainage, and followed for 6 weeks. The median (range) age at presentation was 3 y (4 mo to 11 y). The pleural fluid culture was positive in 24% of patients. Staphylococcus aureus was the most commonly isolated organism. The median (range) duration of injectable antibiotics was 14(14-52) d; median duration of total antibiotics (injectable and oral) was 4 weeks. The median (range) duration of chest tube insertion and hospital stay was 8(5-45) and 14(14-56) days, respectively. All patients were discharged without any surgical intervention besides chest tube drainage. At discharge, pleural thickening was present in 84% and crowding of ribs was seen in 60% of the subjects on radiological examination. All these patients were asymptomatic at discharge. Chest deformity was present in 20% of the patients at 6-weeks follow up. Antibiotics and chest tube drainage is an effective method of treating pyogenic empyema thoracis in children in resource-poor settings.
本研究前瞻性评估了 25 例（2 个月至 12 岁）接受注射用抗生素和胸腔引流治疗并随访 6 周的化脓性脓胸患儿的临床病程。就诊时的中位（范围）年龄为 3 岁（4 个月至 11 岁）。24%的患者胸腔液培养阳性。金黄色葡萄球菌是最常见的分离菌。注射用抗生素的中位（范围）持续时间为 14（14-52）d；总抗生素（注射用和口服）的中位（范围）持续时间为 4 周。胸腔引流管插入和住院的中位（范围）时间分别为 8（5-45）和 14（14-56）天。除了胸腔引流管引流外，所有患者均无需手术干预而出院。出院时，84%的患者在影像学检查时存在胸膜增厚，60%的患者肋骨拥挤。所有这些患者出院时均无症状。6 周随访时，20%的患者出现胸廓畸形。抗生素和胸腔引流管是资源匮乏环境中治疗儿童化脓性脓胸的有效方法。
