Loculated empyema due to tuberculosis in a child

Goussard, Pierre; Morrison, Julie; Appel, Ilse Nadine; Andronikou, Savvas

doi:10.1136/bcr-2017-220315

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Congenital chylothorax (CC) or chylothorax in children is caused by maldevelopment of the lymphatic system, nonimmune hydrops fetalis, several syndromes including Down syndrome, Noonan syndrome (NS), or Turner syndrome, complication of thoracic surgery, right heart failure with high central venous pressure, or tumors [ 8 , 9 ]. Reported cases of empyema associated with preexisting chylothorax are scarce [ 10 , 11 ]. In the present report, we describe a rare case of paediatric empyema associated with CC based on Noonan syndrome.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Oikawa

Ota

Iwasawa

et al. 2021

Case Reports in Pediatrics

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Thoracic empyema usually occurs as a complication of bacterial pneumonia, but in rare cases, it is caused by hematogenous dissemination secondary to nonpulmonary diseases. Congenital chylothorax or chylothorax in children is associated with maldevelopment of the lymphatic system, nonimmune hydrops fetalis, several syndromes including Down syndrome, Noonan syndrome, or Turner syndrome, a complication of thoracic surgery, right heart failure with high central venous pressure, or tumors. There are very few reports of empyema associated with preexisting chylothorax. In the present study, we describe a rare case of thoracic empyema associated with congenital chylothorax and supravalvular pulmonary stenosis associated with clinically diagnosed Noonan syndrome. It is necessary to closely monitor patients with chylothorax because they are at risk of developing severe lung infections, such as pleural empyema or lung abscesses.

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Section: Introductionmentioning

confidence: 99%

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Oikawa

Ota

Iwasawa

et al. 2021

Case Reports in Pediatrics

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“…Though the disease course of TB is indolent typically, the clinical and radiological pictures of pulmonary tuberculosis and TE may overlap with an acute bacterial infection in high TB burden areas 9,10 . Moreover, even in the case of clinically suspicious TB, microbial confirmation of MTB is challenging because pediatric tuberculosis is often paucibacillary 11 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of pediatric empyema secondary to tuberculosis or non‐tuberculosis community‐acquired pneumonia in those who underwent surgery in high TB burden areas

Yang

Chen

et al. 2021

Pediatric Pulmonology

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Introduction Tuberculous empyema (TE) in children is common in high‐TB burden and medical resource‐limited areas. However, studies that evaluate the characteristics of TE in children are sparse. This study aimed to analyze the clinical features of pediatric TE receiving surgical intervention. Methods We performed a retrospective study of children with empyema secondary to community‐acquired pneumonia who underwent surgery in our institution. The clinical characteristics were compared between TE and empyema secondary non‐tuberculosis infection (non‐tuberculosis empyema, NTE). Results One hundred patients were included (27 with TE and 73 with NTE). Stage 3 empyema occupied 81.5% and 45.2% of TE and NTE in this study. The TE children had older age, longer duration of illness, and milder symptoms. Pleural fluid culture was positive for Mycobacterium tuberculosis in 7.4% of patients with TE. Lymph node enlargement, lymph node calcification, and pleural nodules presented in TE with high specificity (93.2%, 98.6%, and 98.5%) but low sensitivity (33.3%, 14.8%, and 29.6%) on CT scan. Thoracoscopy surgery was performed in 14 (51.9%) in TE and 39 (53.4%) in NTE. Postoperative chest‐tube indwelling time was longer (7.85 ± 5.00 vs. 4.89 ± 1.81 days, p < .001), and more patients had incomplete lung expansion after 3 months in TE. Conclusion Tuberculosis infection should be screened in management of children with empyema in high‐TB burden areas. Pediatric TE usually presented at older age and with milder respiratory symptoms. Pleural biopsy during surgery is often necessary to confirm the cause of infection. Thoracotomy is still required in some pediatric TE or NTE with delayed treatment in medical resource‐limited area.

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“…Because few cases are confirmed by microbiological investigations ( 6 ), tuberculin skin test remains a useful tool in establishing the diagnosis of childhood pleural TB. Moreover, like adulthood pleural TB, childhood pleural TB could also develop into loculated effusion, even though effective anti-TB therapy is easily obtained ( 7 ). Loculations may impair pleural drainage and sequester the infectious agents.…”

Section: Introductionmentioning

confidence: 99%

Loculations and Associated Risk Factors of Childhood Pleural Tuberculosis

et al. 2021

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Background: Pleural loculation in childhood pleural tuberculosis (TB) remains a problem in practice, it is usually associated with failure drainage. Therefore, to improve the management of childhood pleural TB, a retrospective study was conducted to identify the risk factors associated with loculated effusion in childhood pleural TB.Methods: Between January 2006 and December 2019, consecutive children (≤15 years old) with tuberculous pleural effusion (definite and possible) were included for further analysis. The demographic, clinical, laboratory, and radiographic features were collected from the medical records. Univariate and multivariate logistic regressions were used to explore the factors associated with the presence of pleural loculation in children with pleural TB.Results: A total of 154 children with pleural TB (definite, 123 cases; possible, 31 cases) were included in our study and then were classified as loculated effusion (n = 27) and non-loculated effusion (n = 127) groups by chest X-ray or ultrasonography. Multivariate analysis revealed that male gender (age-adjusted OR = 3.903, 95% CI: 1.201, 12.683), empyema (age-adjusted OR = 4.499, 95% CI: 1.597, 12.673), peripheral monocytes ≤0.46 × 109/L (age-adjusted OR = 4.122, 95% CI: 1.518, 11.193) were associated with the presence of loculated effusion in children with pleural TB.Conclusion: In conclusion, several characteristics, such as male gender, empyema, and peripheral monocyte count have been identified as risk factors for pleural loculation in children with pleural TB. Our findings may be helpful to improve the management of pleural loculation in childhood pleural TB.

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Loculated empyema due to tuberculosis in a child

Cited by 3 publications

References 3 publications

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Comparison of pediatric empyema secondary to tuberculosis or non‐tuberculosis community‐acquired pneumonia in those who underwent surgery in high TB burden areas

Loculations and Associated Risk Factors of Childhood Pleural Tuberculosis

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