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parapneumonic effusions in children

Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
Michael C Tracy, Roshni Mathew
PURPOSE OF REVIEW: This review aims to provide clinicians engaged in the care of infants and children an update on the current understanding of the epidemiology, etiology, diagnostic evaluation, and clinical management of complicated pneumonia. The review provides timely information surrounding areas of consensus and ongoing research. RECENT FINDINGS: The epidemiology and etiologies of complicated pneumonia continue to evolve over the past several decades in context of the introduction of new vaccines...
March 9, 2018: Current Opinion in Pediatrics
Tahereh Haji, Adam Byrne, Tom Kovesi
Following the introduction of 7-valent pneumococcal vaccine (PCV7), while overall rates of invasive pneumococcal disease and pneumococcal pneumonia in children declined, rates of empyema increased. We examined changes in the incidence of hospitalization for pediatric complicated pneumonia (PCOMP) in Eastern Ontario, Canada, particularly since the introduction of the 13-valent vaccine (PCV13). A retrospective chart review was carried out evaluating previously healthy children admitted with PCOMP, which included empyema, parapneumonic effusion, necrotizing pneumonia, and lung abscess between 2002 and 2015...
March 3, 2018: Children
Vikki G Nolan, Sandra R Arnold, Anna M Bramley, Krow Ampofo, Derek J Williams, Carlos G Grijalva, Wesley H Self, Evan J Anderson, Richard G Wunderink, Kathryn M Edwards, Andrew T Pavia, Seema Jain, Jonathan A McCullers
Background: Recognition that co-infections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance. Methods: We analyzed data from 2219 children hospitalized with CAP and compared demographics, clinical characteristics, and outcomes between groups with viruses alone, bacteria alone, or co-infections. We also assessed the frequency of selected pairings of co-detected pathogens and their clinical characteristics...
December 8, 2017: Journal of Infectious Diseases
Enrique Bernaola, Francisco Gil, Mercedes Herranz, Alberto Gil-Setas, Marcela Guevara, Jesus Castilla
OBJECTIVE: The aim was to assess the effect of the non-systematic pneumococcal conjugate vaccine (PCV) on incidence of pneumonia associated with parapneumonic pleural effusion (PPE) in vaccinated and unvaccinated children. METHODS: Cases were patients aged <15 years who had been diagnosed with pneumonia associated with PPE in a tertiary hospital in Navarra (Spain) between 1995 and 2014. The population aged <15 years and covered by the public health service was used as reference...
September 20, 2017: Pediatric Infectious Disease Journal
Rogerio Knebel, Jose Carlos Fraga, Sergio Luis Amantea, Paola Brolin Santis Isolan
OBJECTIVES: To evaluate the effectiveness of videothoracoscopic surgery in the treatment of complicated parapneumonic pleural effusion and to determine whether there is a difference in the videothoracoscopic surgery outcome before or after the chest tube drainage. METHODS: The medical records of 79 children (mean age 35 months) undergoing videothoracoscopic surgery from January 2000 to December 2011 were retrospectively reviewed. The same treatment algorithm was used in the management of all patients...
August 22, 2017: Jornal de Pediatria
D Griffith, M Boal, T Rogers
AIM: To assess the evolution in management of children with parapneumonic effusion and empyema in a tertiary referral centre. METHOD: We conducted a retrospective case note review of paediatric patients with parapneumonic effusion, pleural effusion and pleural empyema between December 2006 and December 2015. Digital database searches were performed to identify demographic data, referring hospital, radiological and microbiological investigations. Length of stay and morbidity were analysed...
July 24, 2017: Journal of Pediatric Surgery
Gilberto Bueno Fischer, Helena Teresinha Mocelin, Cistiano Feijó Andrade, Edgar E Sarria
Pneumonia is an important health problem in children, and parapneumonic pleural effusion (PPE) is a frequent complication. There is no standard strategy for treating PPE, reflected in the few international guidelines that have been published on the issue. Compared to adults, there is no consensus on the utility of pleural fluid analysis in paediatric PPE. This is because of the lack of good evidence either in favour or against it and the risks of procedural sedation for acquiring pleural fluid for analysis to guide management...
June 1, 2017: Paediatric Respiratory Reviews
Annamaria Deganello, Vasileios Rafailidis, Maria E Sellars, Aikaterini Ntoulia, Kleanthi Kalogerakou, Gary Ruiz, David O Cosgrove, Paul S Sidhu
Pediatric pneumonia can be complicated by necrotizing pneumonia or a parapneumonic effusion either in the form of an empyema or a clear effusion. Ultrasonography (US) and computed tomography represent well-established modalities for evaluation of complicated pediatric pneumonia. Contrast-enhanced ultrasound (CEUS) was recently introduced and is gaining increasing acceptance in pediatric imaging. In this case series, we present our initial experience with both intravenous and intracavitary use of CEUS in children with complicated pneumonia...
September 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
In Ae Yoon, Ki Bae Hong, Hoan Jong Lee, Ki Wook Yun, Ji Young Park, Young Hoon Choi, Woo Sun Kim, Hyunju Lee, Byung Wook Eun, Young Min Ahn, Eun Young Cho, Hwa Jin Cho, Eun Hwa Choi
BACKGROUND: With the emergence of macrolide resistance, concerns about the efficacy of macrolides for the treatment of Mycoplasma pneumoniae (MP) pneumonia in children have been raised. This study aimed to determine the effect of macrolide resistance on the outcome of children who were hospitalized with MP pneumonia. METHODS: Between 2010 and 2015, we performed culture of MP from nasopharyngeal samples obtained from children who were hospitalized with pneumonia at five hospitals in Korea...
June 7, 2017: BMC Infectious Diseases
Alfredo Tagarro, Enrique Otheo, Fernando Baquero-Artigao, María-Luisa Navarro, Rosa Velasco, Marta Ruiz, María Penín, David Moreno, Pablo Rojo, Rosario Madero
OBJECTIVE: To assess whether dexamethasone (DXM) decreases the time to recovery in patients with parapneumonic pleural effusion. STUDY DESIGN: This was a multicenter, randomized, double blind, parallel-group, placebo-controlled clinical trial of 60 children, ranging in age from 1 month to 14 years, with community-acquired pneumonia (CAP) and pleural effusion. Patients received either intravenous DXM (0.25?mg/kg/dose) or placebo every 6 hours over a period of 48 hours, along with antibiotics...
June 2017: Journal of Pediatrics
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
Claudia Giselle Santos Arêas, Geraldo Roger Normando Júnior, Orlando Sandoval Farias Júnior, Irna Carla DO Rosário Souza Carneiro
OBJECTIVE: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD) . METHODS: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
Megan Daniel, Josey Hensley, Lisa Steele, Jennifer Muszynski, Melissa Moore-Clingenpeel, Mark Hall
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Charles A James, Leah E Braswell, Amir H Pezeshkmehr, Paula K Roberson, James A Parks, Mary B Moore
BACKGROUND: Complicated pleural effusion prolongs the hospital course of pneumonia. Chest tube placement with instillation of fibrinolytic medication allows efficient drain output and decreases hospital stay. OBJECTIVE: To evaluate experience with lower fibrinolytic dose for parapneumonic effusions and to assess potential dose stratification based on a simple ultrasound grading system. MATERIALS AND METHODS: We retrospectively reviewed the medical record to identify children and young adults who received fibrinolytic therapy for parapneumonic effusion and had chest tube placement by an interventional radiology service at a single children's hospital...
January 2017: Pediatric Radiology
Florian J Segerer, Karin Seeger, Anna Maier, Christine Hagemann, Christoph Schoen, Mark van der Linden, Andrea Streng, Markus A Rose, Johannes G Liese
OBJECTIVE: To evaluate the initial management of pediatric parapneumonic effusion or pleural empyema (PPE/PE) with regard to length of hospital stay (LOS). METHODS: Collection of pediatric PPE/PE cases using a nationwide surveillance system (ESPED) from 10/2010 to 06/2013, in all German pediatric hospitals. Inclusion of PPE/PE patients <18 years of age requiring drainage or with a PPE/PE persistence >7 days. Staging of PPE/PE based on reported pleural sonographic imaging...
April 2017: Pediatric Pulmonology
Vinicius Pieta Perez, Juliana Caierão, Gilberto Bueno Fischer, Cícero Armídio Gomes Dias, Pedro Alves d'Azevedo
BACKGROUND: Pneumococcal parapneumonic effusion seems to be increasing in children in the postvaccine era and is frequently associated with negative culture. Due to the low yield of culture, culture-independent tools are evaluated. METHODS: Culture-negative pleural fluid specimens from 38 children with parapneumonic effusion were examined for pneumococcal lytA by quantitative polymerase chain reaction (qPCR) and soluble antigen (C-polysaccharide) using an immunochromatographic test (BinaxNow Streptococcus pneumoniae)...
October 2016: Diagnostic Microbiology and Infectious Disease
Katarzyna Krenke, Marta Krawiec, Grażyna Kraj, Joanna Peradzynska, Agnieszka Krauze, Marek Kulus
AIM: The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP). METHODS: Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP. RESULTS: Two-hundred and three patients aged from 2 months to 17 years were enrolled...
July 12, 2016: Clinical Respiratory Journal
George A Syrogiannopoulos, Aspasia N Michoula, Georgios Tsimitselis, Katerina Vassiou, Denise C Chryssanthopoulou, Ioanna N Grivea
BACKGROUND: Parapneumonic effusions in children are usually associated with pneumococcal infections. In Greece, the 7-valent pneumococcal conjugate vaccine was replaced by higher-valent pneumococcal conjugate vaccines (PCVs); 10-valent was introduced in May 2009 and 13-valent (PCV13) in June 2010. Since July 2010, PCV13 has been the most commonly used PCV. In a study conducted at the University General Hospital of Larissa, Central Greece, from January 2012 to January 2016, 85.7% of children born after the implementation of PCV13 and aged 24-59 months had received the complete series (3 + 1 immunization schedule) of PCV13...
October 2016: Infectious Diseases
Katarzyna Krenke, Ewa Sadowy, Edyta Podsiadły, Waleria Hryniewicz, Urszula Demkow, Marek Kulus
BACKGROUND: An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) has been reported in recent studies. As only few data on etiology of PPE/PE in Central Europe have been reported, we undertook a study on the etiology of PPE/PE in children, using both standard culture and molecular techniques. METHODS: This prospective study was conducted between June 2011 and December 2013. Consecutive children with PPE/PE complicating community acquired pneumonia, who required diagnostic/therapeutic thoracentesis were included...
July 2016: Respiratory Medicine
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