The incidence of childhood empyema and pneumococcus-associated haemolytic uraemic syndrome (P-HUS) is increasing. Streptococcus pneumoniae is the most common pathogen causing childhood empyema and the association with invasive streptococcal infections and haemolytic uraemic syndrome (HUS) is well known.1 2 HUS in the absence of diarrhoea (atypical HUS) accounts for only 5% of all UK childhood cases of HUS.2 No data exist on the likelihood of developing HUS in childhood pneumococcal empyema.

We retrospectively reviewed case notes of all children admitted with empyema over a 3-year period to Great Ormond Street Hospital for Children, UK. Our aim was to describe the incidence, morbidity …