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The causative organisms of pediatric empyema in Korea

Korean Journal of Pediatrics 2007;50(1):33-39.
Published online January 15, 2007.
The causative organisms of pediatric empyema in Korea
Hye-yung Yum1, Woo Kyung Kim2, Jin Tak Kim3, Hyun Hee Kim3, Yeong Ho Rha4, Yong Min Park5, Myung Hyun Sohn6, Kang Mo Ahn7, Soo Young Lee8, Su Jong Hong9, Hae Ran Lee10
1Department of Pediatrics, Pochon Cha University
2Department of Pediatrics, College of Medicine, Inje
3University, Department of Pediatrics, College of Medicine, Catholic University of the Korea
4Department of Pediatrics , College of Medicine, Kyunghee University
5Department of Pediatrics, College of Medicine, Eulji University
6Department of Pediatrics, College of Medicine, Yonsei University
7Department of Pediatrics, College of Medicine, Sungkyunkwan University
8Department of Pediatrics, College of Medicine, Ajou University
9Department of Pediatrics, College of Medicine, Ulsan University
10Department of Pediatrics , College of Medicine, Hallym University
소아 농흉 원인균에 대한 다기관 연구(1999. 9-2004. 8)
염혜영1, 김우경2, 김진택3, 김현회3, 나영호4, 박용민5, 손명현6, 안강모7, 이수영8, 홍수종9, 이혜란10
1포천중문의과대학교 소아과학교실
2인제대학교 의과대학 소아과학교실
3가톨릭대학교 의과대학 소아과학교실
4경희대학교 의과대학 소아과학교실
5을지의과대학교 소아과학교실
6연세대학교 의과대학 소아과학교실
7성균관대학교 의과대학 소아과학교실
8아주대학교 의과대학 소아과학교실
9울산대학교 의과대학 소아과학교실
10한림대학교 의과대학 소아과학교실
Correspondence: 
Hae Ran Lee, Email: drran@hallym.or.kr
Abstract
Department of Pediatrics , College of Medicine, Hallym University
Purpose
: In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004.
Methods
: Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea.
Results
: One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels (10.4?.6 g/dL) and increased leukocyte counts (16,234.3?0,601.8/ L). Pleural fluid obtained from patients showed high leukocyte counts (30,365.8?4,073.0/ L), high protein levels (522.3?582.3 g/dL), and low glucose levels (88.1?23.5 mg/dL). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was 28.6?5.3 days.
Conclusion
: We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.
Key Words: Empyema


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