ÇOCUKLARDA PARAPNÖMONİK EFÜZYONLAR: BEŞ YILLIK DENEYİM

Amaç: Çocuklarda solunum yolu enfeksiyonlarının morbidite ve mortaliteye neden olan en önemli komplikasyonlarının başında parapnömonik efüzyonlar gelmektedir. Parapnömonik efüzyon, altta yatan pnömoni ile ilişkili plevral boşlukta gelişen eksüda özelliğindeki sıvı birikimidir. Hastada parapnömonik efüzyon düşünüldüğünde tedavinin erken ve uygun antibiyotiklerle başlanması hayat kurtarıcıdır. Klinik ve laboratuvar bulgularında yeterli düzelme olmayan hastalarda girişimsel ve cerrahi tedavilerin uygun zamanda başlanması morbidite ve mortalitenin azalmasında önemli yer tutmaktadır. Gereç ve Yöntem: Bu çalışmada tek bir merkeze beş yıllık süre içinde solunum yolu enfeksiyonu nedeniyle başvuran hastalardan parapnömonik efüzyon gelişen 100 çocuğun klinik ve laboratuvar bulguları irdelenmiştir. Bulgular: Hastaların ortalama yaşı 52 ay (1,5-156 ay), 52si (%52) erkek, %71’i beş yaş altında idi. Hastane kalış süreleri ortalama 19,6±7,6 gün (1-45 gün) idi. En sık başvuru semptomu ateş, en sık bulgu taşikardi ve retraksiyonlar, en sık laboratuvar bulgusu ise beyaz küre yüksekliğiydi. Plevral sıvı kültüründe en sık üreyen mikroorganizma Staphylococcus aureus idi. Sonuç: Bu çalışma sayesinde, enfeksiyona yol açan patojenlerin belirlenmesi ile spesifik tedavilerin daha erken dönemde başlanmasının morbidite ve mortalitenin önlenmesine yönelik çok önemli katkılar sağlayacağını vurgulamak istedik.

Anahtar Kelimeler:

Parapnömonik efüzyon, ampiyem, çocuklar, kültür, tedavi

PARAPNEUMONIC EFFUSIONS IN CHILDREN: FIVE YEARS EXPERIENCE

Aim: Most severe complication of respiratory tract infections that s causing morbidity and mortality in children is parapneumonic effusion(PPE). PPE is a pleural exudate that is related with primary pneumonia. The early and appropriate antibiotic treatment is very important in follow-up of patients who are diagnosed as parapneumonic effusion and also the timing of interventional and surgical treatment is important to decrease morbidity and mortalitiy in whom clinical and laboratory findings are not cured enough. Materials and Methods: In this study, the clinical and laboratory findings of parapneumonic effusion one hundred patients applied to one center in five years time are discussed. Results: The mean age of patients were 52 months(1.5-156), 52 were male(52%).The 71% of patients were smaller than five years old. The mean duration of hospitalization of patients were 19.6 days(1-45 days). Most frequent spymptom in application was fever, most frequent sign were tachycardia and retractions, most frequent laboratory anormality was high white blood count. The most frequent microorganism in pleural fluid culture was S.aureus. Conclusion: The determination of pathogens causing parapneumonic effusions in our country is very important for starting most suitable treatment early and to decrease morbidity and mortality.

Keywords:

Parapneumonic effusion, empyema, children, culture, treatment,

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