Clinical, functional, and radiological outcome in children with pleural empyema

摘要

Abstract Introduction Few studies have prospectively evaluated recovery process and long‐term consequences of pleural space infections. Objective To evaluate clinical, pulmonary, and diaphragmatic function and radiological outcome in patients hospitalized with pleural empyema. Material and Methods Previously healthy patients from 6 to 16 years were enrolled. Demographic, clinical, and treatment data were registered. At hospital discharge, and every 30 days or until normalization, patients underwent a clinical evaluation, diaphragmatic ultrasound, and lung function testing. Chest radiographs were performed at subsequent visits only if abnormalities persisted. Results Thirty patients were included. Nineteen (63%) were male, with an age of (mean?±?SD) 9.7?±?3.2 years, and body mass index (mean?±?SD) 18.6?±?3. Twelve patients (40%) were treated with chest tube drainage only, 12 (40%) exclusively with surgery, and 6 (20%) completed treatment with surgery due to an ineffective chest tube drainage. At hospital discharge, 26 (87%) of patients had abnormal breath sounds at the site of infection, 28 (93%) had a spirometric restrictive pattern, 19 (63%) diaphragmatic motion impairment, and 29 (97%) presented radiological involvement of pleural space, mainly pleural thickening. All patients had recovered diaphragmatic motion and were asymptomatic at 90‐ and 120‐day follow‐up control, respectively. Then, with a great individual variability, radiological findings, and lung function returned to normal at 60 days (range 30–180) and 90 days (range 30–180) after hospital discharge, respectively. Conclusion Patients with pleural empyema had a complete and progressive recovery, with initial clinical and diaphragmatic motion normalization followed by radiological and lung function recovery.