Barlas ETENSEL, Yasin BULUT, Yavuz TOKGÖZ, Semiha TERLEMEZ

Çocuklarda Nadir Bir Ampiyem Etkeni: Streptococcus pyogenes

Ampiyem, plevral boşlukta pürülan sıvı varlığı olup çocuklarda pnömoninin bilinen ve sık rastlanan bir komplikasyonudur. Plevral ampiyemler, antimikrobiyal tedavi olanaklarının ve plevral boşluk drenaj seçeneklerinin artmasına rağmen çocuk hastalarda da yüksek oranda morbidite ve mortaliteye neden olmaktadır. Streptococcus pyogenes ampiyemin nadir görülen nedenlerindendir. Bu makalede hipotansiyon ve hipoksinin eşlik ettiği ağır bir klinik tabloda başvurmuş olan ve torakas tüpü ile kapalı sualtı drenajına rağmen düzelmeyen ampiyemli on dört yaşında bir kız olgu sunulmuştur. Beş defa fibrinolitik streptokinaz tedavisi uygulandıktan sonra tablosu düzelmiş olup, altı hafta kadar geniş spektrumlu ikili antibiyotik kullanılmıştır. Streptococcus pyogenes’in neden olduğu bu ampiyem tablosunu yönetimindeki güçlükler nedeniyle sunmayı amaçladık.

A Rare Cause of Empyema in Children: Streptococcus pyogenes

Empyema is the presence of purulent material in the pleural cavity, and it is a well-known and frequent complication of pneumonia in children. Despite the new antimicrobial treatment options and the different drainage techniques, parapneumonic pleural empyema still represents a significant cause of morbidity and mortality. Streptococcus pyogenes is an infrequent cause of empyema. In this article, we will present a four-teen years old girl with empyema who presented with severe additional clinical symptoms including hypotension and hypoxia. Streptokinase is five times table fibrinolytic therapy improved after implementation of broad-spectrum antibiotics, has been used up to six weeks. We wanted to present this case because of the challenges that we faced in the management of the disease.

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