Incidence, Management, and Outcome of Childhood Empyema: A Prospective Study of Children in Cambodian Refugee Camps.

Hdl Handle:
http://hdl.handle.net/10144/17662
Title:
Incidence, Management, and Outcome of Childhood Empyema: A Prospective Study of Children in Cambodian Refugee Camps.
Authors:
Fontanet, A L; McCauley, R G; Coyette, Y; Larchiver, F; Bennish, M L
Journal:
The American Journal of Tropical Medicine and Hygiene
Abstract:
To determine the incidence, outcome, and optimal management of empyema, all children less than 15 years of age admitted to Khao-I-Dang Hospital with a diagnosis of empyema during a 23-month period were prospectively studied. Khao-I-Dang Hospital provides care to 137,000 Cambodian children residing in eight refugee camps along the Thai-Cambodian border. Ninety-eight children with empyema were identified, for an annual incidence of 0.37 cases per 1,000 children. All patients had chest tubes inserted on admission, and all were treated with parenteral antibiotics, which included chloramphenicol in 92% of the patients and cloxacillin in 72%. Patients were hospitalized a mean of 30 days, and chest tubes were in place for a mean of 12 days. Surgery was performed on four patients who had bronchopleural fistulas that persisted for more than 14 days. Only one (1%) of the 70 patients treated with cloxacillin required thoracotomy, compared with three (11%) of the 28 patients who did not receive cloxacillin (P = 0.07). In a multiple regression analysis, the presence of pneumatoceles or mediastinal shift on admission chest radiograph, a history of tuberculosis in the family, and an age of more than five years were predictive of a longer duration of chest tube drainage. No patient died in the hospital, and only one patient died in the six months following discharge from the hospital. Chest radiographs that were obtained six months after discharge in 25 patients were all essentially normal, despite marked abnormalities on chest radiographs obtained at discharge. In summary, conservative medical management with the use of chest tubes for these 98 children with empyema resulted in a mortality rate of 1.0%, and should be considered as an effective alternative to the surgical management of patients presenting with this complication.
Affiliation:
Medecins Sans Frontieres, Paris, France.
Publisher:
Published by: American Society of Tropical Medicine and Hygiene
Issue Date:
Dec-1993
URI:
http://hdl.handle.net/10144/17662
PubMed ID:
8279645
Additional Links:
http://www.ajtmh.org
Language:
en
ISSN:
0002-9637
Appears in Collections:
Paediatrics

Full metadata record

DC FieldValue Language
dc.contributor.authorFontanet, A L-
dc.contributor.authorMcCauley, R G-
dc.contributor.authorCoyette, Y-
dc.contributor.authorLarchiver, F-
dc.contributor.authorBennish, M L-
dc.date.accessioned2008-02-07T11:34:00Z-
dc.date.available2008-02-07T11:34:00Z-
dc.date.issued1993-12-
dc.identifier.citationIncidence, Management, and Outcome of Childhood Empyema: A Prospective Study of Children in Cambodian Refugee Camps. 1993, 49 (6):789-98 Am. J. Trop. Med. Hyg.en
dc.identifier.issn0002-9637-
dc.identifier.pmid8279645-
dc.identifier.urihttp://hdl.handle.net/10144/17662-
dc.description.abstractTo determine the incidence, outcome, and optimal management of empyema, all children less than 15 years of age admitted to Khao-I-Dang Hospital with a diagnosis of empyema during a 23-month period were prospectively studied. Khao-I-Dang Hospital provides care to 137,000 Cambodian children residing in eight refugee camps along the Thai-Cambodian border. Ninety-eight children with empyema were identified, for an annual incidence of 0.37 cases per 1,000 children. All patients had chest tubes inserted on admission, and all were treated with parenteral antibiotics, which included chloramphenicol in 92% of the patients and cloxacillin in 72%. Patients were hospitalized a mean of 30 days, and chest tubes were in place for a mean of 12 days. Surgery was performed on four patients who had bronchopleural fistulas that persisted for more than 14 days. Only one (1%) of the 70 patients treated with cloxacillin required thoracotomy, compared with three (11%) of the 28 patients who did not receive cloxacillin (P = 0.07). In a multiple regression analysis, the presence of pneumatoceles or mediastinal shift on admission chest radiograph, a history of tuberculosis in the family, and an age of more than five years were predictive of a longer duration of chest tube drainage. No patient died in the hospital, and only one patient died in the six months following discharge from the hospital. Chest radiographs that were obtained six months after discharge in 25 patients were all essentially normal, despite marked abnormalities on chest radiographs obtained at discharge. In summary, conservative medical management with the use of chest tubes for these 98 children with empyema resulted in a mortality rate of 1.0%, and should be considered as an effective alternative to the surgical management of patients presenting with this complication.en
dc.language.isoenen
dc.publisherPublished by: American Society of Tropical Medicine and Hygiene-
dc.relation.urlhttp://www.ajtmh.org-
dc.rightsArchived on this site with the kind permission of the American Society of Tropical Medicine and Hygiene, www.astmh.orgen
dc.subject.meshAdolescenten
dc.subject.meshAge Factorsen
dc.subject.meshCambodiaen
dc.subject.meshChest Tubesen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCloxacillinen
dc.subject.meshDrainageen
dc.subject.meshEmpyema, Pleuralen
dc.subject.meshFemaleen
dc.subject.meshFeveren
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHumansen
dc.subject.meshIncidenceen
dc.subject.meshInfanten
dc.subject.meshLength of Stayen
dc.subject.meshMaleen
dc.subject.meshProspective Studiesen
dc.subject.meshRefugeesen
dc.subject.meshRegression Analysisen
dc.subject.meshRespirationen
dc.subject.meshSex Factorsen
dc.subject.meshTreatment Outcomeen
dc.titleIncidence, Management, and Outcome of Childhood Empyema: A Prospective Study of Children in Cambodian Refugee Camps.en
dc.contributor.departmentMedecins Sans Frontieres, Paris, France.en
dc.identifier.journalThe American Journal of Tropical Medicine and Hygieneen

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