Guidelines
Parapneumonic Effusion/Pleural Empyema

Parapneumonic Effusion/Pleural Empyema

  • Pneumonia is not responding to initial therapy
  • Unwell child with fever and no clear focus
  • Chest or abdominal pain
  • Respiratory distress
  • Hypoxia
  • Signs of pleural effusion
  • Sepsis with dehydration
  • Hyponatraemia
  • Respiratory failure

Antibiotic Treatment

Note

Paediatrics and pediatric surgery

Request CXR (PA or AP) and ultrasound scan of chest

Give oxygen to maintain the SpO2 >92%

Chest drain may be required

Empirical anti-tuberculosis treatment not recommended unless there is very strong circumstantial evidence

Follow-up

See Myanmar Paediatric Society guidelines for detailed management advice