Assessment of bacteriological profile and outcome of empyema thoracis in hospitalized children in a tertiary care hospital of Raipur city, Chhattisgarh, India

Aradhana Toppo, Shruti Yadu


Background: An empyema is a purulent collection in the pleural space. Empyema Thoracis is a disease that, despite centuries of study, still causes significant morbidity & mortality. It is very commonly seen in children all over the world, more frequently as a complication of pneumonic infections. Pediatric empyema has a much more favorable prognosis compared to adult cases. Empyema thoracic is a common complication of pneumonia. Children of poor socio-economic status and below 3 years of age are most commonly affected.  

Methods: The present prospective observational study was conducted in Department of Surgery, Pediatric Surgery unit, Pt. J. N. M. Medical College and Dr. B. R. A. M. Hospital, Raipur (C.G.) during study period July 2011 to October 2012. This study includes 40 study subjects of the patients of empyema who were diagnosed by the aspiration of gross pus from the pleural space. Complete History was taken, and physical examination was performed in all the cases.

Results: The commonest symptoms at presentation were fever seen in 40 patients (100%), cough with expectoration seen in 36 patients (50%-90%) and dyspnea seen in 32 patients (80%). Left pleura was more commonly affected than the right pleura. The most common organism isolated were Staphylococcus aureus in 28 patients (70%), followed by Klebsiella in 7 patients (17.50%), then E.coli in 3 patients (7.5%) & Streptococcal species in 2 patients (5%). The use of antibiotic therapy alone was effective in 25 patients (62.50%) Antibiotic therapy along with tube thoracostomy was required in 15 patients (37.50%). Operative intervention was required in none of the patients. Out of 40 patients, 28 (70%) had complete lung expansion, while 12 (30%) had only partial expansion. Patients with partial expansion mainly comprised of those who presented late in the course of the disease.

Conclusions: It is concluded from the study that early diagnosis and management is critically important in reducing the unfavourable outcome in pediatric espuma thoracis cases.


Clinico etiological profile, Empyema Thoracis, Tube thoracostomy

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Agostini E, Zocchi L, Mechanical coupling and liquid exchanges in pleural space. Clin Chest Med 1998;19(2):241-60.

Alexiou C, Goyal A, Hunin RK, Hickey MI. Is open thoracotomy still a good ucatineti option for the management of empyema in children. Ann Thoracic Surg. 2003;76:1854-8.

Carey JA, Gould K, Hassan A. Emohverna Thoracis: a role for open thoractomy and decortication. Arch Dis Childhood. 1998;79:510-3.

Antony BB Mohammed KA. Pathophhysiology of pleural space. Semin Respir Infect. 1999.14(1):9-17.

Mennander A1, Laurikka J, Kuukasjärvi P, Tarkka M. Continuous pleural lavage may decrease post operative morbidity in patient ubdergoing thoracotomy for stage 2 thoracic empyema. Eur J Cardiothorac Surg. 2005;27(1):32-4.

Balci AE, Eren Ş, Ülkü R, Eren MN, Management of multiloculatedempema, Thoracotomy vsfibrinolytic treatment. Fur J Cardiothoracic Surg 2002. 22(4):595-8.

Burford, TH and Blades. The influence of Sulphonamide therapy on post pneumonic empyema thoracis. J. Am. Med. Asso.1942.118(12),950-2.

Balci AE, Eren S, Ulku R, Eren MN. Management of multiloculated Empyema Thoracis in children: Thoracotomy versus Fibrinolytic treatment. Eu J Cardiothoracic Surg. 2002;22(4):595-8.

Baranwal AK, Singh M, Marwaha RK, Kumar L. Empyema thoracis: 10-year comparative review of hospitalized children in South Asia. Arch Dis Child. 2003;88(11):1009-14.

Demirhan R, Onan B, Oz K, Halezeroglu S. Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovascul Thorac Surg. 2009;9(3):450-3.

Gupta AK, Lahoti BK, Singh S, Mathur RK, Mishra H, Wadhera S. A study on comprehensive management of acute and chronic empyema thoracis In the pediatric age group and their outcome. Internet J Surg. 2008;14:1.

Cekirdekci A, Koksel O, Goncu T, Burma O, Rahman A, Uyar IS, et al. Asian Cardiovascular and Thoracic Annals. 20008;137-40.

Hilliard TN, Henderson AJ, Hewer SCL. Management of parapneumonic effusion and empyema. Arch Dis Childhood. 2003:89;915-7.

Carey JA, Hamilton JR, Spencer DA, Gould K, Hasan A. Empyema thoracis: a role for open thoracotomy and decortication. Archives of disease in childhood. 1998;79(6):510-3.