All issues > Volume 50(1); 2007

Original Article

Korean J Pediatr. 2007;50(1):33-39. Published online January 15, 2007.

The causative organisms of pediatric empyema in Korea

Hye-yung HY Yum¹, Woo Kyung WK Kim², Jin Tak JT Kim³, Hyun Hee HH Kim³, Yeong Ho YH Rha⁴, Yong Min YM Park⁵, Myung Hyun MH Sohn⁶, Kang Mo KM Ahn⁷, Soo Young SY Lee⁸, Su Jong SJ Hong⁹, Hae Ran HR 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

Correspondence Hae Ran HR 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.

Keywords :Empyema