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Empyema in children

Jinrong Liu, Baolin Tian, Qi Zeng, Chenghao Chen, Chunju Zhou, Huimin Li, Yuelin Shen, Shunying Zhao
BACKGROUND: Mediastinal teratoma is uncommon in children. It can be very difficult to diagnose especially in early stage. Rarely, teratoma may rupture into adjacent structures and lead to lung lesions or pleuritis. The main rarity of our reported cases was the dynamic imaging findings very similar to the developmental process of tuberculosis in patients 1 and 2, the pachypleuritis in patients 2 and 3, the extremely elevated inflammatory markers very similar to empyema in patient 3, and the extremely atypical tumor shape in all patients...
December 4, 2018: BMC Pediatrics
Fouad Madhi, Corinne Levy, Laurence Morin, Philippe Minodier, François Dubos, Ferielle Zenkhri, Marie Aliette Dommergues, Ellia Mezgueldi, Karine Levieux, Stéphane Béchet, Emmanuelle Varon, Robert Cohen
We describe here changes in the bacterial causes of pleural empyema before and after implementation of the 13-valent pneumococcal conjugate vaccine (PCV13) program in France (2009-2017). For 220 (39.3%) of 560 children, a bacterial cause was found. The frequency of pneumococcal infection decreased during the study from 79.1% in 2009 to 36.4% in 2017 (P < .001). Group A streptococcus is now the leading cause of documented empyema (45.5%).
November 8, 2018: Journal of the Pediatric Infectious Diseases Society
N Guignard, T Roujeau, L Saumet, G Gascou, M Mondain, M Akkari
Intracranial empyema is a rare but serious complication of sinusitis in children. Myelodysplastic/myeloproliferative syndromes (MMS), including juvenile myelomonocytic leukemia (JMML), can lead to immunosuppression, thus favouring infections. We report the case of a sphenoid sinogenic retro-clival extradural empyema in a 14-year-old female patient associated with JMML. Treatment consisted in an endonasal transphenoidal drainage of the empyema associated with intravenous antibiotherapy. The patient was thereafter enrolled in chemotherapeutic treatment with Azacitidine...
December 2018: International Journal of Pediatric Otorhinolaryngology
Fumihiro Ochi, Hisamichi Tauchi, Toshihiro Jogamoto, Hiromitsu Miura, Tomozo Moritani, Kozo Nagai, Eiichi Ishii
Streptococcus pyogenes (also referred to as group A streptococci, GAS) causes severe invasive diseases such as bacteremia, necrotizing fasciitis, pneumonia, osteomyelitis, septic arthritis, and toxic shock syndrome in children. However, there are only a few reports on pleural empyema caused by GAS in children. Here, we report the case of a 4-year-old boy who presented with pleural empyema due to GAS after influenza A virus infection. With intravenous antibiotic administration and continuous chest-tube drainage, followed by video-assisted thoracoscopic surgery, his condition improved...
2018: Case Reports in Pediatrics
Eun Ju Shin, Yunsun Kim, Jin-Young Jeong, Yu Mi Jung, Mi-Hee Lee, Eun Hee Chung
PURPOSE: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. METHODS: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. RESULTS: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1-3 years old (48...
September 2018: Korean Journal of Pediatrics
Jian Min Ooi, Kah Peng Eg, Karuthan Chinna, Anna M Nathan, Jessie A de Bruyne, Surendran Thavagnanam
AIM: To investigate baseline characteristics associated with complicated community-acquired pneumonia (CAPc) in Malaysian children. CAPc, such as pleural effusion and/or empyema, is on the rise, especially in Southeast Asian children, and the reasons for this are unknown. METHODS: A retrospective study was conducted on all children aged 2-16 years who were admitted to the University Malaya Medical Centre with community-acquired pneumonia between 2012 and 2014...
September 9, 2018: Journal of Paediatrics and Child Health
Gil Coutinho, Sara Júlio, Ricardo Matos, Margarida Santos, Jorge Spratley
OBJECTIVES: Management of otogenic cerebral venous thrombosis (OCVT) is controversial. Despite the modern antibiotic era OCVT still represents a potential life-threatening condition. This study aims to report the clinical presentation and management in a series of children with OCTV. The coexisting intracranial complications (ICC), the extent of the surgical treatment and the role of hypocoagulation were the analysed outcomes. MATERIAL AND METHODS: Retrospective chart review of patients aged less than 16 years and consecutively treated for OCVT at a tertiary university hospital between January 2007 and March 2015...
October 2018: International Journal of Pediatric Otorhinolaryngology
Muhammad Khalid, Samina Junejo, Fatima Mir
Staphylococci are gram-positive bacteria divided into coagulase positive and coagulase negative classes, Staphylococcus aureus is the most important bacterium of this class. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has changed a lot. It is no more the problem of only hospitalised patients. Children coming from community has also been increasingly affected by MRSA-called community acquired methicillin-resistant (CA-MRSA) infection. The higher severity of CA-MRSA is due to its ability to produce the toxin Panton-Valentine Leukocidin (PVL) associated with staphylococcal cassette chromosome mec (SCCmec) type IV gene...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Michelle M Kelly, Ryan J Coller, Jonathan E Kohler, Qianqian Zhao, Daniel J Sklansky, Kristin A Shadman, Anne Thurber, Christina B Barreda, M Bruce Edmonson
OBJECTIVE: To evaluate trends in procedures used to treat children hospitalized in the US with empyema during a period that included the release of guidelines endorsing chest tube placement as an acceptable first-line alternative to video-assisted thoracoscopic surgery. STUDY DESIGN: We used National Inpatient Samples to describe empyema-related discharges of children ages 0-17 years during 2008-2014. We evaluated trends using inverse variance weighted linear regression and characterized treatment failure using multivariable logistic regression to identify factors associated with having more than 1 procedure...
November 2018: Journal of Pediatrics
Matthew T Cossack, Samantha P Herretes, Abdourahman Cham, Matthew C Sniegowski, David B Lyon
PURPOSE: To describe the natural radiographic course of subperiosteal orbital abscesses that were managed medically in pediatric patients. METHODS: A retrospective case review was undertaken at Children's Mercy Hospitals and Clinics of Kansas City, Missouri. All patients admitted to the hospital and diagnosed as having orbital cellulitis or subperiosteal abscess from 2008 to 2017 were included in the study. Of the 418 patients identified, 15 patients had repeat imaging and did not undergo surgery prior to the second scan...
November 19, 2018: Journal of Pediatric Ophthalmology and Strabismus
Lakshmi Sundararajan, K Prabhu, Venkateswari Ramesh, Janani Sankar
BACKGROUND: Retained appendicolith following appendicectomy, and can cause recurrent abscess in the abdomen and retroperitoneum. CASE CHARACTERISTICS: 11-yr-old boy who presented with subpulmonic abscess and pneumonia following appendicectomy for perforated appendicitis. OBSERVATION: Thoracotomy revealed a thick walled subpulmonic abscess surrounding an appendicolith along with a rent in the posterolateral aspect of the diaphragm. MESSAGE: In children presenting with pus collections and a history of recent appendicectomy, the possibility of a migrating appendicolith should be considered...
July 15, 2018: Indian Pediatrics
Sema Büyükkapu Bay, Rejin Kebudi, Ayça İribaş, Ömer Görgün, Fulya Ağaoğlu, Feryal Gün, Alaettin Çelik, Emin Darendeliler
In children and adolescents with chest pain and dyspnea, pneumonia, pleural effusion, and empyema are the frequent causes in the differential diagnosis. Malignant tumors of the chest wall are rare and most originate from the ribs. In children, the most frequent malignant tumor of the rib is Ewing's sarcoma. Osteosarcomas of the rib are very rare. Osteosarcoma has a predilection for rapidly growing long bones including the femur, tibia and humerus in adolescents. In this paper, we present an adolescent girl who presented with chest pain and dyspnea with osteosarcoma that originated from the rib and extended to the right hemithorax...
March 2018: Türk Pediatri Arşivi
Rabab Rashwan, Julius F Varano Della Vergiliana, Sally M Lansley, Hui Min Cheah, Natalia Popowicz, James C Paton, Grant W Waterer, Tiffany Townsend, Ian Kay, Jeremy S Brown, Y C Gary Lee
Pleural infection/empyema is common and its incidence continues to rise. Streptococcus pneumoniae is the commonest bacterial cause of empyema in children and among the commonest in adults. The mesothelium represents the first line of defense against invading microorganisms, but mesothelial cell responses to common empyema pathogens, including S. pneumoniae, have seldom been studied. We assessed mesothelial cell viability in vitro following exposure to common empyema pathogens. Clinical isolates of S. pneumoniae from 25 patients with invasive pneumococcal disease and three reference strains were tested...
2018: PloS One
Dattatraya Muzumdar, Naresh Biyani, Chandrashekhar Deopujari
BACKGROUND: Subdural empyema denotes the collection of purulent material in the subdural spaceand is commonly seen in infants and older children. In infants, the most common cause is bacterialmeningitis. In older children, sinusitis and otitis media are usually the source for subdural empyema. Theclinical symptomatology is varied and has a wide range including prolonged or recurrent fever, seizures,meningeal irritation, and raised intracranial pressure. It can mimic as well as complicate meningitis and aheightened clinical awareness is therefore paramount...
October 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Megan R Lewis, Thomas A Micic, Iolo J M Doull, Alison Evans
BACKGROUND: Chest tube drainage with fibrinolytics is a cost-effective treatment option for parapneumonic effusion and empyema in children. Although the additional use of ultrasound (US) guidance is recommended, this is rarely performed in real time to direct drain insertion. OBJECTIVE: To evaluate the effectiveness and safety of real-time US-guided, radiologically placed chest drains at a tertiary university hospital. MATERIALS AND METHODS: This was a retrospective review over a 16-year period of all children with parapneumonic effusion or empyema undergoing percutaneous US-guided drainage at our centre...
September 2018: Pediatric Radiology
Shally Awasthi, Krishna K Yadav, Monika Pandey, Abbas A Mahdi, Nidhi Awasthi
BACKGROUND: High morbidity and mortality due to community-acquired pneumonia (CAP) is seen in children under 5 years of age in India. Besides identified risk factors for CAP, there may be a phenotype-genotype association with cytokines, resulting in enhanced inflammatory response resulting in the adverse outcome (AO), namely complications and death. AIM: To assess the association of IL1RA gene polymorphism on serum levels of IL1RA and with AO in children under 5 years of age hospitalized with WHO-defined severe CAP...
September 2018: Pediatric Pulmonology
Eleftherios Neromyliotis, Dimitrios Giakoumettis, Evangelos Drosos, Ioannis Nikas, Alexios Blionas, George Sfakianos, Marios S Themistocleous
Background: Infratentorial subdural empyemas in children are extremely rare and potentially lethal intracranial infections. Delay in diagnosis and therapy is associated with increased morbidity and mortality. Case Description: A 4-year-old boy presented with cerebellar signs following a failed treatment of otitis media. Imaging studies revealed a subdural empyema and left transverse and sigmoid sinus thrombosis. The empyema was evacuated operatively and antibiotic treatment was initiated and administered for 6 weeks...
2018: Surgical Neurology International
Catarina Silva-Costa, Maria João Brito, Marcos D Pinho, Ana Friães, Sandra I Aguiar, M Ramirez, Jose Melo-Cristino
Despite use of 7-valent pneumococcal conjugate vaccine, incidence of pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]) is reportedly increasing globally. We cultured and performed PCR on 152 pleural fluid samples recovered from pediatric patients in Portugal during 2010-2015 to identify and serotype Streptococcus pneumoniae. We identified only 17 cases by culture, but molecular methods identified S. pneumoniae in 68% (92/135) of culture-negative samples. The most frequent serotypes were 3, 1, and 19A, together accounting for 62% (68/109) of cases...
July 2018: Emerging Infectious Diseases
Gülsüm Alkan, Sevgi Keles, İsmail Reisli
Background: Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder (PID) that typically presents with hypogammaglobulinemia and impaired antibody production. Objectives: This study aimed to promote the awareness of CVID, whose clinical spectrum is quite broad. Methods: The demographic, clinical, and laboratory characteristics of 12 children (seven males and five females) with CVID were analyzed retrospectively. The patients were diagnosed using the diagnostic criteria of the European Society for Primary Immunodeficiencies...
2018: International Journal of Pediatrics
P Goussard, Robert Gie, Jacques Janson, Savvas Andronikou
Empyema necessitans is a rare complication of acute bacterial pneumonia, especially in children. It is a complication of empyema characterised by the extension of pus from the pleural cavity into the thoracic wall to form a mass of purulent fluid in the adjacent soft tissue. An inflammatory chest wall mass following pneumonia caused by Streptococcus pneumonia in a six-month-old infant is reported. The case emphasises that children presenting with persistent fever and a painful chest wall mass following pneumonia should be investigated immediately as there might be an urgent need for surgery...
May 23, 2018: Paediatrics and International Child Health
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