In this section
Febrile child Pneumonia
Empyema is defined as the presence of pus in the pleural space. Parapneumonic effusion is a pleural fluid collection in association with an underlying pneumonia.
Empyema is rare in children (0.7% of pneumonia cases). This guideline covers diagnosis and management of both complications of pneumonia.
Red flag features in Red
As for pneumonia:
AP/PA CXR:
CT chest not routinely indicated. Consider if risk of complications, following treatment failure or query regarding alternative aetiology.
CRP is useful as marker of treatment success
U&E [SIADH/HUS]
Blood culture
Pneumococcal PCR on blood
Pleural fluid
When to admit/consult local paediatric team, or who/when to phone consult at RCH:
Ward Management
Discharge requirements:
Respiratory Fellow
General Surgical Fellow
Paediatric Empyema Thoracis: Recommendations for Management
Position statement from the Thoracic Society of Australia and New Zealand www.thoracic.org.au