[The diagnostic-therapeutic problems in acute suppurative destructive pleuropulmonary diseases in childhood].

Over a ten-year period (1985 through 1994), 183 children with acute purulent-destructive pleuropulmonary disease undergo treatment in the pediatric chest surgery department of the Medical Faculty-Sofia. Their distribution by age is as follows: 0-1 y. -28 children (15.2 per cent), 1-3 y.-67 (36.4 per cent), and 3-15 y. -88 (48.4 per cent). To assess the lung condition, and specify the form of disease and therapeutic approach, conventional and contrast roentgenography, thoracoscopy and CAT are performed. St. aureus is the etiological contributory cause in 28.9 per cent of patients, gram-negative flora-in 32.4 per cent, mixed microbial flora-in 33.2 per cent, and in the remainder no causing agent is isolated (15.5 per cent). All patients are subjected to complex treatment. In 23 children (12.5 per cent) the pleural complication is treated by pleural puncture, and in 138 (75.5 per cent)-by drainage of the pleural cavity. In 22 children (12.0 per cent) thoracotomy is done with varying in size pulmonary resection. In six children (3.2 per cent) the outcome is fatal.