Paediatric thoracic empyema in an Ethiopian referral hospital.

Abstract

To analyse underlying conditions, clinical manifestations, aetiologic agents and management of empyema thoracis and to determine the outcome of the disease. A retrospective study. Ethio-Swedish Children's Central referral (teaching) Hospital, Addis Ababa, Ethiopia. Thirty eight patients with a discharge diagnosis of non-tuberculous thoracic empyema seen from January 1988 to December 1992. The incidence was 2.7/1000 admissions, which is higher than that reported elsewhere. Sixty six per cent of the patients were under five. Pneumonia was the antecedent illness in almost all cases. Fever, dyspnoea and signs of respiratory distress and effusion were the commonest presenting features. Bacteriological examination revealed Staphylococcus aureus as the commonest aetiologic agent (58%). All patients were treated with antibiotics, and drainage of the empyema was effected by closed thoracostomy in 71% of the cases, while the rest were managed with thoracentesis alone. The case fatality rate was 16%. A long hospital stay and high rate of complications were also observed. Empyema is not rare in our practice. Early diagnosis and proper treatment of pneumonia prevents the development of empyema. Therefore, establishing an efficient management protocol that is relevant to our particular set up is required.