An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological associations

Clin Infect Dis. 2002 Feb 15;34(4):434-40. doi: 10.1086/338460. Epub 2002 Jan 3.


We investigated the increasing incidence of pediatric empyema during the 1990s at Primary Children's Medical Center in Salt Lake City. Of 540 children hospitalized with community-acquired bacterial pneumonia (CAP) who were discharged from 1 July 1993 through 1 July 1999, 153 (28.3%) had empyema. The annual population incidence of empyema increased during the study period from 1 to 5 cases per 100,000 population aged <19 years. Streptococcus pneumoniae was identified as the most common cause of CAP with or without empyema; serotype 1 accounted for 50% of the cases of pneumococcal empyema. Patients with empyema were more likely to be >3 years old, to have > or =7 days of fever, to have varicella, and to have received antibiotics and ibuprofen before admission to the hospital, compared with patients without empyema (P<.0001 for each factor). The increasing incidence of empyema was associated with infection due to S. pneumoniae serotype 1, outpatient treatment with certain antibiotics, ibuprofen use, and varicella.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Empyema / epidemiology*
  • Empyema / etiology
  • Female
  • Humans
  • Incidence
  • Male
  • Pneumonia, Pneumococcal / complications
  • Pneumonia, Pneumococcal / epidemiology*
  • Pneumonia, Pneumococcal / microbiology
  • Risk Factors
  • Serotyping
  • Streptococcus pneumoniae*