Abstract
Empyema thoracis, defined as the accumulation of pus in the pleural space, is a rare entity in the neonatal period. There are very few cases described in the medical literature and there are still no treatment protocols in the management of empyema in neonates. In older infants and children, intrapleural fibrinolytics and surgery are often utilized since treatment of complicated parapneumonic effusions with chest tube and antibiotics alone often fail due to the viscous fluid and presence of loculations. Presented here is a case of a term neonate who exhibited symptoms of respiratory distress on the sixth day of life. Imaging modalities revealed massive left sided pleural effusion with loculations and mass effects. Pleural fluid was grossly pus and exudative in nature. Gram stain revealed gram-positive cocci but culture was negative. Empiric broad-spectrum antibiotics and chest tube drainage were utilized and patient was discharged after forty-seven days of hospital admission. In spite of prolonged hospital stay, patient survived with no complications. Therefore, nonoperative therapy could still be an option for neonates with loculated empyema. The key to success in treatment is immediate identification of effusion, prompt initi...Continue Reading
References
Jan 1, 1984·American Journal of Perinatology·W A LongE N Kraybill
Aug 1, 1995·Chest·R W Light
Jul 1, 1994·The Pediatric Infectious Disease Journal·K A Nathavitharana, M Watkinson
Jul 1, 1997·Acta Paediatrica·J ThaarupJ Stjernholm
Jun 3, 2004·Pediatrics·Karen D SchultzMary L Brandt
Feb 1, 2005·Thorax·I M Balfour-LynnUNKNOWN Paediatric Pleural Diseases Subcommittee of the BTS Standards of Care Committee
Jun 3, 2005·Pediatrics·Jeffrey R AvansinoDavid R Flum
Jun 28, 2006·Acta Paediatrica·Gustavo RochaElisa Proença
May 31, 2007·Current Opinion in Pulmonary Medicine·Gustavo Rocha
Feb 23, 2008·The Annals of Thoracic Surgery·Helen Christopoulou-Aletra, Niki Papavramidou
Jun 18, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Klaus LohmeierThomas Hoehn
Nov 26, 2009·AJR. American Journal of Roentgenology·Jessica KurianSamuel Weinstein
Mar 4, 2011·Indian Journal of Pediatrics·Amarendra Narayan Prasad
Nov 1, 2011·Pediatrics and Neonatology·Yueh-Ting ShihHua-Pin Chang
Mar 19, 2013·Indian Pediatrics·D NarayanappaAnil Kumar
Jun 13, 2014·Tuberculosis and Respiratory Diseases·Moon Jun Na
Jun 10, 2015·Clinical Pediatrics·Mohamed A Hendaus, Ibrahim A Janahi
Jul 28, 2016·Pediatrics International : Official Journal of the Japan Pediatric Society·Lily Myung-Jin ChaShin Won Yoon
Nov 7, 2016·Langenbeck's Archives of Surgery·Martin ReichertAndreas Hecker
Jan 1, 2016·The Turkish Journal of Pediatrics·Zeynep Gökçe Gayretli-AydınAyşe Kaman