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 Vol. 16 No. 2, August 2006
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AAP Grand Rounds 16:17-18 (2006)
© 2006 American Academy of Pediatrics

INFECTIOUS DISEASE (UNIFORM SERVICES)

Rapid Microbial Diagnosis of Empyema

Source: Monnier AL, Carbonnelle E, Zahar J-R, et al. Micro-biological diagnosis of empyema in children: comparative evaluations by culture, polymerase chain reaction, and pneumococcal antigen detection in pleural fluids. Clin Infect Dis. 2006;42:1135–1140; doi:10.1086/502680[Medline]

The first 20% of the full text of this article appears below.

French investigators prospectively compared the diagnostic value of Gram stain, standard bacterial culture, pneumococcal antigen detection by latex particle agglutination (LPA) test, and polymerase chain reaction (PCR) of pleural fluid samples from children with empyema. Over a 4-year period (January 2001 to December 2004), 78 otherwise healthy children (median age 3.9 years; range, 1 month to 15 years) with community-acquired empyema (LDH >1000 IU/L, pH <7.2, glucose <40 mg/dL, and albumin >30 g/L) were enrolled.

Pleural fluid was collected after empiric antibiotic therapy was used for a mean of 5 days (range, 1–11 days). Microbial etiology was confirmed in 60 (77%) children. No bacterial association was found by either culture or PCR in the remaining 18 (23%) patients. Sixteen of these 18 patients had received early antibiotic treatment and only a small volume of pleural fluid was collected from . . . [Full Text of this Article]

Mobeen H. Rathore, MD, FAAP1, Mike Dubik, MD, FAAP2 and Leslie Barton, MD, FAAP3
1 Pediatric Infectious Diseases and Immunology, University of Florida Health Science Center and Wolfson Children’s Hospital, Jacksonville, FL
2 Pediatrics, Uniformed Services, Naval Medical Center, San Diego, CA
3 Pediatrics, University of Arizona School of Medicine, Tucson, AZ