To study the clinical profile of children with pleural effusion at a Tertiary Care Center in North India: A prospective study

Abstract

Introduction: Pleural effusion is the most common manifestation of pleural disorders and is mostly secondary to bacterial infections in children. Aims and Objectives: The primary objective was to study the clinical presentation of pleural effusion in hospitalized children. The secondary objective was to establish the etiology. Methods: A prospective observational study conducted from April 2014 to September 2015. Children >1 month and <14 years diagnosed to have pleural effusion on clinical and radiological examination were included in the study. Data regarding demographic profile, presenting complaints, immunization history, anthropometry, biochemical and radiological investigations, and the outcome of the patients were collected. Results: Seventy-five patients were included in this study. The mean age of the patients was 69.97±48.23 months. Regarding etiology of pleural effusion, it was parapneumonic in 35 (46.6%), empyema in 18 (24%), transudative in 12 (16%), tubercular in 9 (12%), and malignant (non-Hodgkin’s lymphoma) in 1 (1.3%) case. The presenting complaints were fever (82.6%), cough (78.7%), respiratory distress (69.3%), chest pain (36%), and abdominal pain (9.3%). There was no sex predominance. About 16% patients were severely malnourished. Severe anemia was present in 5 (6.7%) patients. None of them required decortication surgery, and none of the patients expired during hospitalization. Conclusion: Pleural effusion is a major health problem with parapneumonic effusion still beingthe most common etiology. Our study also confirmed that fever, cough, and respiratory distress were the most common presenting complaints and most of the children were malnourished. A high index of suspicion is required to avoid delays in diagnosis that may influence treatment and outcome.