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SUMMARY: Ütine GE, Özçelik U, Kiper N, Dogru D, Yalçin E, Çobanoglu N, Pekcan S, Kara A, Cengiz AB, Ceyhan M, Seçmeer G, Göçmen A. Pediatric pleural effusions: etiological evaluation in 492 patients over 29 years. Turk J Pediatr 2009; 51: 214-219.
Pediatric pleural effusions present a changing profile over time, both in terms of etiological subgroups and causative microorganisms in parapneumonic effusions. This retrospective study aimed to review pediatric pleural effusions in a large cohort over a 29-year period, with special emphasis on the etiological subgroups and microbiological causes of parapneumonic effusions. The medical records of 492 pediatric patients were reviewed for a comparison of subgroups of pleural effusions and microbiological causes of parapneumonic effusions between three decades. Parapneumonic effusions (381 patients) made up 77.4% of the group. Tuberculous pleurisy decreased, but malignant effusions doubled in number over time. A causative microorganism was identified in 34.6% overall, with Staphylococcus aureus and Streptococcus pneumoniae being the two most common. Relative frequency of S. aureus decreased, whereas pneumococci and Haemophilus influenzae were more frequent in recent years.
Key words: pediatric pleural effusion, parapneumonic, tuberculous, malignant effusion, empyema.
Pediatric pleural effusions present a changing profile over time, both in terms of etiological subgroups and causative microorganisms in parapneumonic effusions. The changing spectrum of causative agents in pediatric parapneumonic effusions is among the current topics on the subject1-2. The causative agent may be difficult to estimate empirically because of changes in frequency of microbial agents over years1-2, incomplete sensitivity and specificity of different methods in detecting the agents3-6, and increasing incidence of sterile empyemas as a result of wide utility of broad spectrum anti-microbial agents2. Reviews of causative agents over long periods of time help reveal this changing profile of causative microorganisms and would be clinically useful.
The current study was conducted to provide a general descriptive information on pediatric pleural effusions seen at Hacettepe University Children's Hospital between 1975 and 2003, with a main focus on frequencies of effusion subtypes and etiological causes.
Material and Methods
The medical records of 492 pediatric patients with pleural effusions admitted to Hacettepe University ihsan Dogramaci Children's Hospital between 1975 and 2003 were available for review. These included patients in whom pleural effusions were the reason for referral as...