{"id":9,"date":"2007-07-11T20:00:55","date_gmt":"2007-07-11T19:00:55","guid":{"rendered":"http:\/\/resource.bmj.com\/adc-archimedes\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/"},"modified":"2007-07-11T20:00:55","modified_gmt":"2007-07-11T19:00:55","slug":"what-is-the-best-treatment-for-empyema","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/","title":{"rendered":"What is the best treatment for empyema?"},"content":{"rendered":"

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 \u2018white out\u2019 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?<\/p>\n

<\/p>\n

Clinical Bottom Line<\/strong><\/p>\n

There is no evidence to support a better clinical outcome from VATS compared to a chest drain with intrapleural fibrinolytic in children with empyema. Most children will do well with this therapy alone. [Grade B]<\/p>\n

Read more<\/a><\/p>\n

<\/u>Authors<\/strong><\/p>\n

Orlena Kerek (Respiratory Registrar, Bristol Royal Hospital for Children) [orlenakerek@yahoo.com]<\/p>\n

Tom Hilliard, Paediatric Respiratory Consultant, Bristol Royal Hospital for Children<\/p>\n

John Henderson, Reader in Paediatric Respiratory Medicine, University of Bristol<\/p>\n","protected":false},"excerpt":{"rendered":"

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 […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[153,215,86,82,87],"tags":[],"class_list":["post-9","post","type-post","status-publish","format-standard","hentry","category-answered","category-empyema","category-fibrinolytics","category-therapy","category-vats"],"yoast_head":"\nWhat is the best treatment for empyema? - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is the best treatment for empyema? - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"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. 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