The treatment of complex parapneumonic effusions in children remains controversial, with some advocating less invasive, strictly medical management and others supporting a more aggressive approach of thoracotomy with or without decortication. Recent advances, including video-assisted thoracoscopic surgery and intrapleural fibrinolytic therapy, offer new options for effective treatment. We repor...

BACKGROUND Matrix metalloproteinases (MMPs) have been implicated in the escalation of fibrosis and remodeling which are central to the subsequent progression of a parapneumonic pleural effusion to empyema. OBJECTIVES The aim of this study was the assessment of MMP-2, MMP-8 and MMP-9 in parapneumonic pleural effusions in order to examine their value in the differentiation between uncomplicated...

BACKGROUND Community-acquired pneumonia (CAP) complicated by parapneumonic effusion/empyema is an infectious syndrome commonly encountered by physicians caring for children in Canada. OBJECTIVE To investigate the incremental benefit of novel molecular testing for the microbiological diagnosis of pediatric CAP complicated by parapneumonic effusion/empyema in Canada. METHODS A convenience sam...

OBJECTIVE The management of parapneumonic effusions in children is controversial. The objective of this study was to evaluate the effectiveness and safety of intrapleural tissue plasminogen activator (tPA) in children who require tube thoracostomy for drainage of a complicated parapneumonic effusion. METHODS An observational cohort study was used to compare children who were treated with intr...

This study aimed to identify the bacterial etiology of empyema thoracis or parapneumonic pleural effusions in Thai children, with a focus on pneumococcus. This hospital-based, descriptive study included children aged < or = 16 years, diagnosed with empyema thoracis or parapneumonic pleural effusion, from whom a pleural fluid (PF) sample was taken between January 2008 and November 2009. PF and b...

BACKGROUND AND PURPOSE Parapneumonic effusion and empyema are recognized complications of bacterial pneumonia. Optimal management in children, especially the duration of parenteral antibiotics and the role of surgery, is controversial. This study analyzed the clinical characteristics, management, outcome, and bacterial etiology of 59 patients with complicated parapneumonic effusion and empyema ...

OBJECTIVES To describe the microbiological characteristics of a cohort of patients with complicated parapneumonic effusion and empyema thoracis, and to identify the potential risk factors for adverse outcomes, with particular reference to the choice of empirical antibiotics, intrapleural fibrinolytics, adherence to management guidelines, and input from pulmonologists. DESIGN Retrospective rev...

Pneumonia is the second most common cause of pleural effusion. The presence of pleural fluid makes the prognosis in patients with pneumonia worse and causes a higher mortality rate. This is why it is very important to undertake suitable treatment as soon as possible. Most parapneumonic pleural effusions resolve with antibiotic alone, but sometimes more invasive treatment is necessary. Therapeut...