Management of pleural sepsis in Nigerian children

Paediatric empyema thoracis in Zaria, Nigeria

From 1977 to 1986 at the Ahmadu Bello University Hospital in Zaria, the diagnosis of empyema thoracis was made in 150 children representing 0.35% of all paediatric admissions. Empyema was a complication of pneumonia in 98 of 100 cases reviewed, of whom 70 were 3 years old or younger. There was no sex or side preference. Fifty-nine patients were severely ill on admission, with a mean symptom duration of 21 days. In many of them, anaemia, protein-energy malnutrition, measles and gastro-enteritis were present as associated illnesses. Staphylococcus aureus was the most frequent bacterial isolate (39%), of which 83% of the cultures were sensitive to cloxacillin. Adequate rehydration, systemic antibiotics and tube thoracostomy drainage performed in 80 patients were more successful than repeated needle aspiration. Fourteen of the children died, six absconded and 80 were discharged home.

A clinical evaluation of Suprapen (amoxicillin plus flucloxacillin) in the management of childhood thoracic empyema

Twenty-one children, all suffering from thoracic empyema, were treated with a combination of antibiotic therapy (Suprapen) and tube thoracostomy. A satisfactory clinical response with radiological and laboratory confirmation was seen in all but one patient, thus obviating the need for major surgery. Suprapen may be considered as a first line antibiotic in such cases of pleural sepsis in the absence of bacteriological confirmation of infection.