PLEURAL EMPIEMA. THERAPEUTIC OPTIONS

Pleural empyema is a common clinical entity in the pediatric age group and consists of the accumulation of purulent fluid in the pleural cavity as a response to an infectious process. It occurs in approximately 10% of patients with respiratory infections. It is more common in children under 5 years of age, immunosuppressed, with infantile cerebral palsy, congenital heart disease, chronic pulmonary diseases such as cystic fibrosis, as well as in patients with bacterial, viral or fungal pneumonias.

The clinical picture is characterized by malaise, fatigue, anorexia, respiratory distress manifested by polypnea, intercostal and subclavicular pulls, cough, chest pain and fever.

Among the current therapeutic options for this disease is supportive care, which includes hospitalization, hydration, supplemental oxygen as needed, life support measures and broad-spectrum antibiotics. Surgery as a definitive treatment has its indications, which should be applied in a timely manner to avoid complications.

The prognosis of this condition is still reserved and the evolution will be better if the diagnosis and treatment is performed early. Even so, nowadays the prognosis is more favorable thanks to the creation, expansion and equipment of pediatric intensive care units, the application of broad-spectrum antimicrobials, the timely practice of thoracentesis and pleurotomy, the use of fibrinolytics, as well as videothoracoscopic surgery. All this, together with the professional experience in the care of patients with this disease, allows a better and faster resolution of it.