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首页> 外文期刊>Sao Paulo Medical Journal >The etiology of extensive pleural effusions with troublesome clinical course among children
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The etiology of extensive pleural effusions with troublesome clinical course among children

机译：小儿广泛性胸腔积液的病因及临床过程

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CONTEXT: In S?o Paulo, pneumonia is the main infectious cause of death among children. Parapneumonic pleural effusion is a possible complication and has to be treated surgically when the patient does not respond to antibiotics. OBJECTIVE: Assessment of the etiology of complicated parapneumonic pleural effusions that needed surgical intervention. TYPE OF STUDY: Retrospective study. SETTING: University hospital of the University of S?o Paulo. METHOD: Analysis of 4,000 files on children hospitalized with pneumonia from November 1986 to November 1996 had shown that 115 of these children presented a total of 117 cases of pleural empyema that required surgical procedures. The children's clinical condition was assessed in relation to radiological findings and to their nutrition and immunization status. Previous antimicrobial therapy and pleural effusion bacterioscopy were also evaluated. RESULTS: Streptococcus pneumoniae was the agent found most commonly, as frequently in blood cultures as in pleural effusions. DISCUSSION: Data on vaccination coverage, birth weight and nutritional status are analyzed and compared to other publications. We observed that pleural effusion has a high potential for discomfort, and in most cases it is not a complication of the first pulmonary disease episode. Previous use of antibiotics interfered with culture positivity. The agent most frequently found was Streptococcus pneumoniae, which is in accordance with the findings from other authors. Nonetheless, the antibiotics used to treat the patients after the procedure were the same used in non-complicated pneumonias, which has led us to conclude that the worse outcome in this cases was not due to drug resistance. CONCLUSION: The bacteriological profile in our series of complicated pneumonia cases was similar to what has been described for non-complicated pneumonia cases. Future studies will be necessary to determine why these children presented a worse outcome.
机译：背景：在圣保罗，肺炎是儿童死亡的主要传染原因。肺炎旁胸腔积液是一种可能的并发症，当患者对抗生素无反应时必须进行手术治疗。目的：评估需要手术干预的复杂性肺炎旁胸膜腔积液的病因。研究类型：回顾性研究。地点：圣保罗大学医院。方法：对1986年11月至1996年11月住院的肺炎儿童的4,000份文件进行的分析表明，其中115例患儿共有117例需要手术治疗的胸膜积液。对儿童的临床状况进行了放射学检查，营养和免疫状况的评估。还评估了先前的抗菌治疗和胸腔积液细菌学检查。结果：肺炎链球菌是最常见的病原体，在血液培养中与在胸腔积液中一样频繁。讨论：分析了有关疫苗接种覆盖率，出生体重和营养状况的数据，并与其他出版物进行了比较。我们观察到胸腔积液有很大的不适感，而且在大多数情况下，这并不是首例肺部疾病的并发症。以前使用抗生素会干扰培养阳性。最常见的病原体是肺炎链球菌，与其他作者的发现一致。尽管如此，手术后用于治疗患者的抗生素与非复杂性肺炎相同，这使我们得出结论，在这种情况下，较差的结局不是由于耐药性所致。结论：我们的一系列复杂性肺炎病例的细菌学特征与非复杂性肺炎病例的细菌学特征相似。未来的研究将是必要的，以确定为什么这些孩子表现出较差的结果。

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