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. 2007 Nov;96(11):1686-92.
doi: 10.1111/j.1651-2227.2007.00511.x. Epub 2007 Sep 19.

Development of Parapneumonic Empyema in Children

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Development of Parapneumonic Empyema in Children

Elina Lahti et al. Acta Paediatr. .

Abstract

Aim: The aim of the study was to find clinical predictors for parapneumonic empyema in children.

Methods: Thirty-seven children treated for parapneumonic empyema at the Department of Pediatrics, Turku University Hospital, were retrospectively evaluated. Two distinct comparison groups of children with uncomplicated community-acquired pneumonia with alveolar consolidation (n = 37 in both groups) were included. Clinical and laboratory data on admission as well as fever kinetics and inflammatory markers during hospitalization were analyzed.

Results: In a multivariate analysis, a history of prolonged fever, tachypnoea and pain on abdominal palpation on admission were the most significant clinical predictors for empyema. On admission, serum C-reactive protein levels were higher among children with empyema than among those with uncomplicated pneumonia (means, 234 mg/L vs. 178 mg/L; p = 0.037). During hospitalization, prolonged fever and persistence of high serum C-reactive protein levels were associated with empyema. At the initial evaluation, pleural fluid was not reported in 35% of children with empyema.

Conclusions: Early recognition of developing empyema is challenging. Children with pneumonia presenting with prolonged fever, tachypnoea, pain on abdominal palpation and high serum C-reactive protein levels are at risk for parapneumonic empyema.

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