Epidemiology and Outcome of Parapneumonic pleural effusion among the children admitted in Dhaka Shishu Hospital

Akhand Tanzih Sultana1, Md. Mahmudul Huda2, Jotsna Ara Begum3, Mamun Miah4,
Kazi Zahidul Hoque5, Md. Ruhul Amin6

Background: Parapneumonic effusions (PPE) frequently occur as complications of
pneumonia. Published data from developing countries is limited.
Objective: This study was conducted to describe the epidemiological characteristics,
clinical findings and the treatment outcome of this disease.
Methods: A prospective study was done on 35 cases of parapneumonic pleural effusion
from 2 months to 18 years of age who were admitted in Dhaka Shishu Hospital from
May 2014 to September 2015. Diagnosis of pleural effusion was confirmed by chest
radiography and aspiration of pleural fluid. All children were treated with parental
antibiotics, chest tube or surgery according to British Thoracic Society guidelines.
Results: Positivity was higher in male children (77.42%). The most common age
group affected was 1-5 years. Most common presenting complaints were fever (93.55%),
breathlessness (87.10%) and cough (74.19%). All (100%) children had diminished
chest movement, dull on percussion, diminished vocal resonance and diminished
breath sound on the affected side. The majority of the pleural collections were on the
right pleural space. About one-third of the parapneumonic effusions were empyemic.
All children were treated with parental antibiotics and 10 patients required chest
tube drainage. Remaining 11 patients underwent primary surgical management.
Conclusion: Parapneumonic pleural effusion was common in younger age. Antibiotic
coverage and chest tube drainage was adequate in most cases. However, patients
with extensive pleural involvement need surgery.
Key words: parapneumonic pleural effusion (PPE), empyema, vocal resonance, chest
tube drainage


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