Article Text

PDF
Update on the causes, investigation and management of empyema in childhood
  1. Woolf Walker1,
  2. Robert Wheeler2,
  3. Julian Legg1
  1. 1Regional Paediatric Respiratory Unit, Southampton University Hospitals NHS Trust, Southampton General Hospital, Southampton, UK
  2. 2Regional Paediatric Surgical Unit, Southampton University Hospitals NHS Trust, Southampton General Hospital, Southampton, UK
  1. Correspondence to Dr Julian Legg, Regional Paediatric Respiratory Unit, Southampton University Hospitals NHS Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; julian.legg{at}suht.swest.nhs.uk

Abstract

Despite being recognised for over two millennia and having an increasing incidence in many countries, the management of childhood empyema remains controversial. This review examines the recent literature on its causes and investigation then focuses on its treatment. Following a trial of appropriate intravenous antibiotics, the evidence would currently support the use of chest drain insertion with urokinase instillation as first line treatment with video-assisted thoracoscopic surgery to be used for failure of medical management. A treatment algorithm is proposed to guide clinical practice.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.