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Journal of Tropical Pediatrics 1995 41(3):185-188; doi:10.1093/tropej/41.3.185
© 1995 by Oxford University Press
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Empyema Thoracis in Hospitalized Children in Kelantan, Malaysia

Wan Maziah, MD, K. E. Choo, FRCP (Lond, F.din, Glasg), Joel G. Ray, MD and W. A. Wan Ariffin, FRCP (Edin)

Department of Paediatrics, Universiti Sains Malaysia Kubang Kerian, Kelantan, Malaysia

Correspondence: Dr K. E. Choo, Department of Paediatrics, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelan tan, Malaysia

In this study, 31 cases of childhood empyema thoracis admitted over 41 years to the Hospital Universiti Sains Malaysia, in Kelantan, Malaysia, were retrospeclively reviewed. Twenty-two males and nine females were included, with a mean age of 1.9 years (range: 26 days to 7 years). Frequent symptoms were fever, cough, and dyspnoea, while common signs were temperature above 38°C, decreased breath sounds, dullness to chest percussion, and intercostal recession. Radiography demonstrated unilateral moderate to large effusioas in 68 per cent of cases, while consolidated lung was seen in 45 per cent of patients. Pleural fluid cultures were positive for Staphylococcus aureus (48 per cent), Streptococcus pneunwniae (7 per cent), while no growth was seen in 42 per cent of cases. Ninety-four per cent of children had a blood leukocytosis above 10000 cell/mm3 but blood cultures were negative in 21 out of 26 patients (81 per cent). Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Antibiotics and pleural tap(s) were used in the remainder. Patients stayed in hospital for an average of 20.7 days (range: 4–52 days). Surgical intervention was necessary in only four children. The mortality rate it the time of discharge was zero, with 100 per cent radiographic resolution among the 23 patients who were followed-up.


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