Intrapleural streptokinase for the treatment of complicated parapneumonic effusion and empyema in 2 newborns

J Pediatr Surg. 2012 Oct;47(10):e41-4. doi: 10.1016/j.jpedsurg.2012.07.034.


The management of complicated parapneumonic effusions by conventional first-line treatment with closed intercostal tube drainage and antibiotic therapy may fail because of thick viscous fluid and multiple pleural space loculations. Intrapleural fibrinolytic treatment is a non-invasive therapeutic option. In this report, we present successful use of intrapleural streptokinase for complicated parapneumonic effusion and empyema in 2 newborns. Intrapleural fibrinolytic therapy with streptokinase appears to be a safe and effective adjunctive therapy of choice and may have significant benefit even in newborns with complicated parapneumonic effusion and empyema, and thus, it can obviate surgical intervention.

Publication types

  • Case Reports

MeSH terms

  • Empyema, Pleural / complications
  • Empyema, Pleural / drug therapy*
  • Empyema, Pleural / etiology
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Infant, Newborn
  • Pleural Effusion / complications
  • Pleural Effusion / drug therapy*
  • Pleural Effusion / etiology
  • Pneumonia, Bacterial / complications
  • Streptokinase / administration & dosage*


  • Fibrinolytic Agents
  • Streptokinase