• Joanne M Langley, James D Kellner, Nataly Solomon, Joan L Robinson, Nicole Le Saux, Jane McDonald, Rolando Ulloa-Gutierrez, Ben Tan, Upton Allen, Simon Dobson, and Heather Joudrey.
• Department of Pediatrics, Dalhousie University, Halifax, Canada. jmlangle@dal.ca
• Bmc Infect Dis. 2008 Jan 1;8:129.

BackgroundAlthough the incidence of serious morbidity with childhood pneumonia has decreased over time, empyema as a complication of community-acquired pneumonia continues to be an important clinical problem. We reviewed the epidemiology and clinical management of empyema at 8 pediatric hospitals in a period before the widespread implementation of universal infant heptavalent pneumococcal vaccine programs in Canada.MethodsHealth records for children<18 years admitted from 1/1/00-31/12/03 were searched for ICD-9 code 510 or ICD-10 code J869 (Empyema). Empyema was defined as at least one of: thoracentesis with microbial growth from pleural fluid, or no pleural fluid growth but compatible chemistry or cell count, or radiologist diagnosis, or diagnosis at surgery. Patients with empyemas secondary to chest trauma, thoracic surgery or esophageal rupture were excluded. Data was retrieved using a standard form with a data dictionary.Results251 children met inclusion criteria; 51.4% were male. Most children were previously healthy and thoseConclusionEmpyema occurs most commonly in children under five years and is associated with considerable morbidity. Variation in management by center was observed. Enhanced surveillance using molecular methods could improve diagnosis and public health planning, particularly with regard to the relationship between immunization programs and the epidemiology of empyema associated with community-acquired pneumonia in children.

26 keywords...

hide…