Purulent Pleurisy of Children: About 42 Cases in Senegal

Abstract

Introduction: Purulent pleurisy refers to the presence in the large pleural cavity of a purulent, cloudy or lemon-yellow liquid, but containing altered polynuclear cells. It is a frequent pathology, the epidemiology of which is constantly changing in Africa and throughout the world. This is why we conducted this study with the aim of updating epidemiological, clinical, bacteriological and therapeutic data. Methods: This is a retrospective, mono-centric, descriptive study including the records of children aged 0 to 15 years old hospitalized during the period from 20 May 2014 to 26 March 2019 at the Children's Hospital of Diamniadio for purulent pleurisy. The data were entered and analyzed using sphinx, Excel under Windows 8 and SPSS software. Results: We counted 42 cases of purulent pleurisy, i.e. a hospital frequency of 0.7%. Most of the patients were aged between 2 and 12 years (48%). The average age at diagnosis was 46 months. The sex ratio was 2.5. Most of the children came from parents with a low socio-economic status (64%); fever was the most frequent reason for consultation (50%), followed by cough (33%) and respiratory difficulty (29%). In all cases, a liquid effusion syndrome was objectively diagnosed (100%), tachycardia in 36% of cases and a pulmonary condensation syndrome in 33% of patients. X-rays showed a predominantly right-sided effusion (62%) which was very abundant in 71% of cases. In bacteriology, staphylococcus aureus was the most frequently isolated germ (75%), followed by streptococcus pneumoniae (20%) and group D streptococcus (5%). Biology showed an average hemoglobin level of 9.2 and there was a predominantly neutrophilic hyperleukocytosis in 98% of cases. All patients had received antibiotic therapy and pleural drainage in 76% of cases. Mortality was 10%. Conclusion: In the light of this work, we insist on the importance of early diagnosis and adequate management of purulent pleurisy in order to avoid complications and after-effects. Thus, antibiotic therapy should be more closely monitored, and its administration better codified to reduce bacterial resistance and germ selection.