Evaluation of Pediatric Empyema at Children’s Hospital from 2003 to 2013

The diagnosis and treatment of pediatric empyema can vary greatly. Diagnosis, etiology, and treatment of empyema, and their effects on hospital Length of Stay (LOS) were investigated. We analyzed 136 children. Mean LOS was 14.99 days. For imaging, 8% (10/131) had a chest ultrasound, 60% a CT scan (79/131), 14% (18/131) a chest x-ray and 18% (24/131) had both CT scan and ultrasound. For intervention 18% (24/136) received only antibiotics, 50% (69/136) a chest tube, 25% (33/136) a Video Assisted Thoracoscopic Surgery (VATS), and 7% (10/136) an open procedure. Size of effusion had no impact on intervention type or LOS. Etiology was identified in 49% (66/136). 9% (12/136) had MRSA, 19% (26/136) had Streptococcus pneumoniae, 12% (17/136) had Group A Beta Hemolytic Streptococci (GABHS), and 8% (11/136) had others. Children age 2 to 12 and those receiving antibiotics only had a shorter LOS. Empyema from “other' organisms' category had a longer LOS. The highest mean white blood cell count (31.71 thousand/cmm) was in GABHS and the highest CRP in Streptococcus pneumoniae (24.96 mg/dl). Ultrasound was less frequently used than CT scan. A shorter LOS was seen when antibiotics alone were used. Organisms in the “other' category had a longer LOS.