Factors Associated With Complicated Pneumonia in Paedatrics

Community acquired pneumonia is the cause of morbidity and mortality in children worldwide ,complication of Community acquired pneumonia in paedatrics include para -pneumonic pleural effusion ,empyema, necrotizing pneumonia and lung abscess.( Sawicki GS,2008) Pediatric para-pneumonic pleural effusion and empyema are considered different stages of the same pathophysiological process in which pleural inflammation causes fluid to accumulate in the pleural cavity, Necrotizing pneumonia results from pulmonary necrosis and tissue liquefaction. ( Ira Erlichman, MD,2017) Recent reports have characterized the clinical presentation of this complication and have shown favorable outcomes in children.( Sawicki GS,2008) Complicated pneumonia was defined as clinical pneumonia and the presence of pleural effusion, empyema (EMP) or Para-pneumonic childhood EMP was defined as the presence of pus (purulent fluid and/or WBC count>5,000 permm3) or bacteria in the pleural fluid.

PPE was defined by pleural fluid not fitting criteria of EMP and the diagnosis of NP was made by the presence of multiple cavity gas-filled spaces within a pulmonary consolidation on chest X-rays or liquefaction of lung tissue according to CT scans as reviewed by a pediatric radiologist .( Ira Erlichman, MD 2017) Among patients with pneumonia AS MANY AS half may develop pleural effusions (i.e., fluid in THE PLEURAL SPACE); of these, 5-10 % MAY DEVELOP EMPYEMAN Ingeneral , "complicated pneumonia" refers to pneumonia accompanied by pleural effusion.( Byington CL,2010) Empyema is a serious COMPLICATIO characterized by pus and bacteria in the pleural space which may progress to necrosis, cavitation, or fistulas in the thoracic cavity. S. pneumoniae is the most common cause of complicated pneumonia in children (an M. A. Fletcher ETT 2014) Empyema among children age below 19 years in Utah (USA) (1994-2007)] and Australia(1998-2010)ranged from 0.9 to 12.5 per 100,000 (Byington CL,2010)the incidence was highest in children aged 0-4 and tend to increase over time. (Strachan RE,2013).