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WHAT IS THE BEST TREATMENT FOR EMPYEMA?

Bristol Royal Hospital for Children, Bristol, UK; orlenakerek@yahoo.com
Bristol Royal Hospital for Children, Bristol, UK
University of Bristol, Bristol, UK

The first 150 words of the full text of this article appear below.

A 7-year-old child with a history of cough and fever for 1 week, has bronchial breathing over her left lower zone on auscultation. A diagnosis of lobar pneumonia is made, confirmed on plain chest x ray, and she is treated with appropriate intravenous antibiotics. However, she continues to have a spiking fever and develops signs of a left sided pleural effusion. Repeat chest x ray shows a "white out" of the left chest with no mediastinal shift. She is referred to the regional thoracic centre for consideration of thoracotomy and drainage of a left sided parapneumonic effusion. Should she be referred to the surgeons and if so, what should they do?

Structured clinical question
In children with an empyema [patient] should video assisted thoracoscopy (VATs) [intervention] or percutaneous chest drain with fibrinolytic therapy [intervention] be used to resolve symptoms [outcome]?

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