Abstract
Parapneumonic effusion is usually defined in children as accumulation of pleural fluid during the acute bacterial pnuemonia and rarely in association with viral pneumonia and tuberculous pleuritis. Empyema shows the presence of pus in the pleural space. Pleural infection is a continuum, but classically it has been divided into three stages: exudative, fibropurulent and organisational. Main bacterial causes are Pneumococcus, Streptococcus, pyogenes and Staphylococcus aureus. There are two common patterns of presentation of parapneumonic effusions. When we are suspicious of parapneumonic effusion, we use standard diagnostic therapy management according to recommendations from BTS guidelines. If a significant amount of pleural liquid persists and lung function has been compromited, then we are speaking about complicated parapneumonic effusion and chest drainage is indicated. If septations and loculations appear in pleural space, intrapleural installation of fibrinolytics is necessary. Using Streptokinase is safe and effective, reduces the need for surgical treatment and when combined with other therapy managements, it leads to complete recovery of the child.
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