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2020, Number 3

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Rev Cubana Pediatr 2020; 92 (3)

Guide of clinical practice on parapneumonic pleural efussion and pleural empyema

Cabrera RJ, Santana González-Chávez A, Santana SJA, Abad CC, Caraballoso GVJ, Rodríguez NBR

Language: Spanish
References: 24
Page: 1-13
PDF size: 612.84 Kb.


ABSTRACT

The accumulation of purulent fluids or the presence of bacteria in the Gram´s stain in the pleural liquid is defined as empyema. It can develop in the 2 to 12% of children with pneumonia, generally the bacterial one. It evolves in three phases: exudative, fibrinopurulent and organized. The clinical picture is a consequence of respiratory manifestations with persistent fever and general discomfort. The radiology studies are important for the diagnosis and the pleural ultrasound is the preferred imaging modality because it confirms the presence and volume of the pleural fluid, as well as the existence of septa. The treatment is based in the use of antibiotic therapy and the drainage through a pleurostomy; if there is presence of septa, slough or the biochemical study of the pleural liquid informs of pH 7, glucose 2.2 mmol/L, LDH 1000 UI, so it is started the use of intrapleural streptokinase. The surgical treatment is indicated if there is a clinical and radiological worsening after finishing the use of fibrinolytics, persistence of sepsis associated to pleural collection in spite of the drainage, fibrin shell that hampers pulmonar reexpanding; and bronchopleural fistula with pneumothorax.


REFERENCES

  1. Winnie GB, Lossef SV. Pleuritis, derrame pleural y empyema. En: Kliegman, Stanton, St. Geme, Schor, editores Nelson. Tratado de pediatría. 20ma ed. Barcelona: Elsevier; 2016. p. 231 - 3.

  2. Ibrahim AJ. Khoulood GF, Sheldon LK. Epidemiolgy; clinical presentation; and evaluation of parapneumonic effusion and empyema in children. E.E. UU: UptoDATE Information Clinicians Trust; 2019. [acceso 08/06/2019]. Disponible en: www.uptodate.com/contents/epidemiolgy-clinical-presentation-and-evaluation-of-parapneumonic-effusion-and-empyema-in-children

  3. Bradley JS, Byington CL, Shah SS.The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis 2011;53:e25.

  4. Philips JB. Epidemiolgy; clinical presentation; and evaluation of parapneumonic effusion and empyema in the neonate. E.E. UU: UptoDATE Information Clinicians Trust; 2019. [acceso 01/06/2019]. Disponible en: www.uptodate.com/contents/epidemiolgy-clinical-presentation-and-evaluation-of-parapneumonic-effusion-and-empyema-in-the-neonate

  5. Olarte L, Barson WJ, Barson RM.Pneumococcal Pneumonia Requiring Hospitalization in US Children in the 13-Valent Pneumococcal Conjugate Vaccine Era. Clin Infect Dis. 2017; 64:1699.

  6. Byington CL, Hulten KG, Ampofo K. Molecular epidemiology of pediatric pneumococcal empyema from 2001 to 2007 in Utah. J Clin Microbiol 2010;48:520.

  7. Strachan RE, Cornelius A, Gilbert GL. Bacterial causes of empyema in children, Australia, 2007-2009. Emerg Infect Dis 2011;17:1839.

  8. Antachopoulos C, Tsolia MN, Tzanakaki G. Parapneumonic pleural effusions caused by Streptococcus pneumoniae serotype 3 in children immunized with 13-valent conjugated pneumococcal vaccine. Pediatr Infect Dis J. 2014;33:81.

  9. Abad Cerulia C, Santana Santana JA, Santana González-Chávez A, Hernández Rodríguez N, Rodríguez Tápanes L. Empiema pleural. Guía aprobada por consenso en el 4to. Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica. Las Tunas: 4to. Taller Nacional; 2005 [acceso 01/06/2019]. Disponible en. http://www.sld.cu/galerias/doc/sitios/renacip/manual_empiema_pleural.doc

  10. Puligandla PS, Laberge JM. Infections and Diseases of the Lungs, Pleura and Mediastinum. In: Coran AG, Adzick NS, Krummel TM, Laberge JM, Caldmore A, Shanberge R, editores. Pediatric surgery. 7th ed. EE.UU: Elsevier; 2012. p. 870 - 4.

  11. 11.Peter SD. Acquired Lesions of the Lung and Pleura. En: Holcomb KW, Murphy GW, Ostlie JP, Peter SD editores. Ashcraft`s Pediatric surgery. 7th ed. EE.UU: Elsevier; 2020. p. 361-5.

  12. Cortés-Telles A, Laguna BP, Vázquez-Callejas A. Derrame paraneumónico y empiema. A propósito de una revisión integral. Evid Med Invest Salud 2014;7(1):24-33.

  13. Islam S, Calkins CM, Goldin AB. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg. 2012;47:2101.

  14. Spinale JM, Ruebner RL, Kaplan BS, Copelovitch L. Update on Streptococcus pneumoniae associated hemolytic uremic syndrome. Curr Opin Pediatr. 2013;25:203.

  15. Ipswich MA. Pleural effusion. DynaMed Plus EBSCO Information Services. 1995 - Record No. T474331. E.E. UU: UptoDATE Information Clinicians Trust; 2018. [acceso 01/06/2019]. Disponible en: https://www.dynamed.com/topics/dmp~AN~T474331. Registration and login required.

  16. Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 2009;39:527.

  17. Davis TR, Evans HR, Murtas J. Utility of blood cultures in children admitted to hospital with community-acquired pneumonia. J Pediatr Child Health. 2017;53:232.

  18. Neuman MI, Hall M, Lipsett SC. Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia. Pediatrics. 2017;140:213-5.

  19. Myers AL, Hall M, Williams DJ. Prevalence of bacteremia in hospitalized pediatric patients with community-acquired pneumonia. Pediatr Infect Dis J. 2013;32:736.

  20. Mani CS, Murray DL. Acute pneumonia and its complications. In: Long SS, Pickering LK, Prober CG, editors. Principles and Practice of Pediatric Infectious Diseases, 4th ed. Edinburgh: Elsevier Saunders; 2012. p. 235.

  21. Breuer O, Picard E, Benabu N. Predictors of Prolonged Hospitalizations in Pediatric Complicated Pneumonia. Chest. 2018;153:172.

  22. Gilbert DM, Moellering RC, Eliopouluos GM, Chambers HF. Sanford guide for antimicrobial therapy. E.E. UU: UptoDATE Information Clinicians Trust; 2020. [acceso 01/06/2019]. Disponible en: http://www.sanfordguide.com

  23. Ibrahim AJ. Khoulood GF. Management and prognosis of parapneumonic effusion and empyema in children. E.E. UU: UptoDATE Information Clinicians Trust; 2019. [acceso 01/06/2019]. Disponible en: www.uptodate.com/contents/management-and-prognosis-of-parapneumonic-effusion-and-empyema-in-children

  24. Agarwal N, Taneja S, Saxena R, Verma A. Clinical profile, complications, morbidity and outcome of empyema thoracis in children in a tertiary care centre. Int J Contemp Pediatr 2018;5:967-72. [acceso 01/06/2019]. Disponible en: http://dx.doi.org/10.18203/2349-3291.ijcp20181523




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