The causative organisms of pediatric empyema in Korea

Yum, Hye-yung; Kim, Woo Kyung; Kim, Jin Tak; Kim, Hyun Hee; Rha, Yeong Ho; Park, Yong Min; Sohn, Myung Hyun; Ahn, Kang Mo; Lee, Soo Young; Hong, Su Jong; Lee, Hae Ran

Original Article

Korean Journal of Pediatrics 2007;50(1):33-39.
Published online January 15, 2007.

The causative organisms of pediatric empyema in Korea

Hye-yung Yum¹, Woo Kyung Kim², Jin Tak Kim³, Hyun Hee Kim³, Yeong Ho Rha⁴, Yong Min Park⁵, Myung Hyun Sohn⁶, Kang Mo Ahn⁷, Soo Young Lee⁸, Su Jong Hong⁹, Hae Ran 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

소아 농흉 원인균에 대한 다기관 연구(1999. 9-2004. 8)

염혜영^¹^, 김우경^²^, 김진택^³^, 김현회^³^, 나영호^⁴^, 박용민^⁵^, 손명현^⁶^, 안강모^⁷^, 이수영^⁸^, 홍수종^⁹^, 이혜란^¹⁰

^¹포천중문의과대학교 소아과학교실
^²인제대학교 의과대학 소아과학교실
^³가톨릭대학교 의과대학 소아과학교실
^⁴경희대학교 의과대학 소아과학교실
^⁵을지의과대학교 소아과학교실
^⁶연세대학교 의과대학 소아과학교실
^⁷성균관대학교 의과대학 소아과학교실
^⁸아주대학교 의과대학 소아과학교실
^⁹울산대학교 의과대학 소아과학교실
^¹⁰한림대학교 의과대학 소아과학교실

Correspondence:
Hae Ran 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.

Key Words: Empyema