A study on clinical profile of empyemathoracis in a tertiary care centre

Author: 
Kedarnath Das, Mangal Charan Murmu and Subrat Kumar Mohapatra

Introduction: An empyema Thoracis is a purulent collection in the pleural space. It is a disease that, despite centuries of study, still causes significant morbidity and mortality. Empyema  thoracis in children  is  very  commonly  seen  all over  the world, more frequently  as  a complication of pneumonic infections. In paediatric patients, empyema thoracis complicates pneumonia  36%  to 57%  of  the time with a range of incidence between 0.4 and 6.0 cases per 1000 pediatric admissions. It constitutes   approximately 5- 10% of cases  seen by pediatrician in India. Light et al (1980) proposed 3 lights criteria  for diagnosis  which is  still acceptable  universally. Aim & Objective: To find out the clinical profile, average hospital stay, complication and outcome following management & long term sequale on follow up in patients of empyema thoracis between the age group of 1 month-14 years with special reference to organism isolated & their sensitivity pattern. Method: It is a prospective study. All the children fulfilling the inclusion criteria were taken into study. details examinations, history, clinical examination was done. The data obtained were analysed.   Observation: Incidence of empyema  thoracis was 0.39 among all cases  admitted during study period. Male children are more commonly affected. Pneumonia was the most common predisposing factor associated in more than 54% of cases. Duration of   Fever in present study 51% were found less than 7 days. Raised temperature (98 %), tachypnea (87 %), intercostals tenderness (82%) were the most common clinical signs. 80 cases (85%) improved by ICTD along with antibiotics, 8 cases required only aspiration and antibiotics.  Conclusion: Empyema thoracis was most common in 1-5 years children with male preponderance. Higher incidence was seen in spring season and in malnourished children. Light’scriteria is a sensitive diagnostic criteria for diagnosing empyema in children. Staphylococcus aureus was the predominant causative organism. Vancomycin, linezolid, imipenam, piperacillin & tazobactam, ceftriaxone are still the sensitive antibiotic in most of cases. Appropriate antibiotics for at least 2 weeks and early instillation of intercostals tube drainage must be done in every case to drain the pus and to prevent septicaemia, as it is a important cause of mortality.

Page: 
5146-5155
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DOI: 
http://dx.doi.org/10.24327/23956429.ijcmpr202005880
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