Korean J Pediatr.
2007 Jan;50(1):33-39. 10.3345/kjp.2007.50.1.33.
The causative organisms of pediatric empyema in Korea
- Affiliations
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- 1Department of Pediatrics, Pochon Cha University, Korea.
- 2Department of Pediatrics, College of Medicine, Inje University, Korea.
- 3Department of Pediatrics, College of Medicine, Catholic University of he Korea, Korea.
- 4Department of Pediatrics, College of Medicine, Kyunghee University, Korea.
- 5Department of Pediatrics, College of Medicine, Eulji University, Korea.
- 6Department of Pediatrics, College of Medicine, Yonsei University, Korea.
- 7Department of Pediatrics, College of Medicine, Sungkyunkwan University, Korea.
- 8Department of Pediatrics, College of Medicine, Ajou University, Korea.
- 9Department of Pediatrics, College of Medicine, Ulsan University, Korea.
- 10Department of Pediatrics, College of Medicine, Hallym University, Korea. drran@hallym.or.kr
- KMID: 2278744
- DOI: http://doi.org/10.3345/kjp.2007.50.1.33
Abstract
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PURPOSE: In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004.
METHODS
Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea.
RESULTS
One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels (10.4+/-1.6 g/dL) and increased leukocyte counts (16,234.3+/-10,601.8/microliter). Pleural fluid obtained from patients showed high leukocyte counts (30,365.8+/-64,073.0/microliter), high protein levels (522.3+/-1582.3 g/dL), and low glucose levels (88.1+/-523.5 mg/dL). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was 28.6+/-15.3 days.
CONCLUSION
We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.
