Study on Clinico – Etiological Co-Relation and Management Modalities in Children with Pleural Effusion

ABSTRACT

Introduction: Pleural effusion, abnormal accumulation offluid in pleural space, differ Signicantly in children from adultsin relation to etiology, management and outcome. Objective ofthis study is to identify common causes of pediatric pleuraleffusions; to describe the clinic-etiological profile and itsco-relation with radiological finding and management andearly outcome of pleural effusion in children. Study Design:Prospective Hospital based Observational study.Material and Methods: Patients with pleural effusion wereevaluated by chest X-ray and USG in all cases and CT scanthorax in difficult cases. Pleural fluid samples were analyzedfor glucose, protein, cytology and culture, CBNAAT (asand when required). Intercostal tube drainage was given inempyema cases VATS and decortications Was done in specificcase.Results: Commonest etiology of pleural effusion wasempyema (52% cases), followed by tubercular pleural effusion(26% cases). Most common organism isolated from pleuraleffusion was Mycobacterium tuberculosis (21.79%) followedby staphylococcus aureus. There is signicant correlationamong age and etiology (p value 0.015), tuberculosisoccurred more in older children and empyema occurredmore in younger children. There is no signicant correlationamong weight and etiology (p value 0.200), between genderand etiology of pleural effusion (p value >.05) in our study.There is signicant correlation of pleural fluid neutrophilcount (p value 0.001), lymphocyte count (p value 0.002)with etiology, but no correlation was seen with protein (pvalue 0.060), LDH (p value 0.353), glucose (p value 0.799)in our study. The successful management of pleural effusionlines in intravenous administration of antibiotics along withintercostals drainage tube.Conclusion: Regarding etiology of pleural effusion empyemaand tuberculosis are very commonly encountered in clinicalpractice. Staphylococcus aureus is the most common pathogen.Regardless of which treatment is used in pleural effusion, theoutcome for children is generally excellent.