Management of complicated parapneumonic effusion and empyema thoracis in children at the University Teaching Hospital of Kigali in Rwanda: A case study

Objective: To describe the management options of Parapneumonic effusion and empyema thoracis in the department of Pediatrics at the University Teaching Hospital of Kigali (CHUK).
Methods: A retrospective descriptive study was conducted in 52 children with parapneumonic effusion (PPE) and empyema thoracis in the department of Pediatrics at CHUK for 3 years. The data collected included demographic information, clinical presentation, laboratory investigations and hospital length of stay (LOS).
Results: The study involved 52 patients with whom 25 were males (48.1%) and 27 females (51.9%). The age-interval was between 5 to 144 months (12years) old and the mean age was 37.67 months (3years and 1 month). The mean hospital LOS was 26.53 days, and those who spent more than 30 days were considered to have a prolonged hospital LOS. The disease-related hospital mortality rate was 11.5% (6 cases) and all were under 4 years-old. Almost all patients were treated medically with chest tube drainage and antibiotics; only 1 case required thoracotomy and pleural decortication. Chest tube lasted 1-10 days in 63.5%. Cephalosporins (3rd generation) were the cornerstone of intravenous antibiotics and their mean treatment duration time was 17.23 days.
Conclusion: PPE and empyema thoracis are severe complications of pneumonia. The study intended to describe the overview of hospital prevalence of the conditions. The mortality rate remains high in the subgroup of under 4 years-old; though many children responded well to the intravenous antibiotics and chest tube drainage.