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Volume 14, Number 9—September 2008


Pediatric Parapneumonic Empyema, Spain

Ignacio ObandoComments to Author , Carmen Muñoz-Almagro, Luis A. Arroyo, David Tarrago, David Sanchez-Tatay, David Moreno-Perez, Sahar S. Dhillon, Cristina Esteva, Susanna Hernandez-Bou, Juan J. Garcia-Garcia, William P. Hausdorff, and Angela B. Brueggemann
Author affiliations: Virgen del Rocio Children’s Hospital, Seville, Spain (I. Obando, L.A. Arroyo, D. Sanchez-Tatay); Sant Joan de Deu Hospital, Barcelona, Spain (C. Muñoz-Almagro, C. Esteva, S. Hernandez-Bou, J.J. Garcia-Garcia); Spanish Reference Laboratory for Pneumococci, Madrid, Spain (D. Tarrago); Carlos de Haya Children’s Hospital, Malaga, Spain (D. Moreno-Perez); University of Oxford, Oxford, UK (S.S. Dhillon, A.B. Brueggemann);; GlaxoSmithKline Biologicals, Rixensart, Belgium (W.P. Hausdorff);

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Table 5

Characteristics of children hospitalized with PPE, by serotype category, excluding patients with serious underlying disease 
(n = 3)*

Characteristic HIDP serotypes, n = 84 Serotype 3, n = 11 LIDP serotypes, n = 13 p value
Median age, mo (range) 55.6 (2–180) 37.9 (9–71) 24 (2–36) 0.0001†
Median hospital stay,‡ d (range) 13 (4–38) 15 (9–29) 10 (6–24) 0.042§
Complications, % patients¶ 10 45 0 0.004#

*PPE, pediatric parapneumic empyema; HIDP, high invasive disease potential; LIDP, low invasive disease potential. HIDP serotypes: 1, 5, 7F, and 14; LIDP serotypes: 6A, 9V, 19A, and 19F (16,17,19). All results shown were statistically significant (p<0.05). There were no significant differences between groups for the following variables: median days febrile preadmission; preadmission antimicrobial therapy; intensive care unit admission; mean leukocyte count; mean C-reactive protein; mean pleural fluid glucose; mean pleural fluid pH; mean lactate dehydrogenase; median days to thorachocentesis; referral; primary fibrinolytics or thoracoscopy; or oxygen requirement >4 d.
†HIDP was compared with LIDP by post hoc analysis.
‡Since being admitted to first center.
§No significant differences between individual groups by post hoc analysis (p = 0.023 for comparison between serotype 3 and LIDP)
¶Complications included (no. patients): bronchopleural fistula (3), pyopneumothorax (2), pneumatoceles (4), lung abscess (1), mechanical ventilation
>48 h (2), severe anemia requiring blood transfusion (2), severe hypoalbuminemia requiring seroalbumin replacement (1).
#Serotype 3 compared with HIDP and LIDP groups combined.

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