Clinical Characteristics and Treatment Outcomes in Pediatric Patientswith Empyema

Background: The frequency and effectiveness of treatment methods for pediatric empyema in Iran have not been thoroughly investigated. Objective: This study aimed to assess the incidence, clinical features, and treatment outcomes of empyema in children. Methods: This retrospective study evaluated the medical records of children diagnosed with empyema at Abuzar Hospital (Ahvaz, Iran) during one year. Results: A total of 100 pediatric patients with empyema (53 boys and 47 girls; mean age, 5.51 ± 3.21 years) were included. The mean time from symptom onset to diagnosis was 6.41 ± 1.66 days. Pigtail catheters were inserted in 44 patients, while 36 were managed with chest tubes. Intrapleural fibrinolytic therapy was administered to 69 patients, of whom 67 (97%) were successfully treated without surgery. Among the 31 patients who did not receive fibrinolytic therapy, 19 required surgical intervention. Overall, 79% of the patients were successfully treated without surgery, whereas 21% required surgery. The mean hospital stay was significantly shorter in patients treated with fibrinolysis (14 days) than in those who did not receive fibrinolytic therapy (29 days). Discussion: These findings highlight the therapeutic value of intrapleural fibrinolytic therapy in managing pediatric empyema. This approach appears to be effective and resource-efficient, particularly in clinical settings where access to advanced surgical procedures may be limited. Conclusion: This study revealed a notably high incidence of pediatric empyema in southwestern Iran. Intrapleural fibrinolytic therapy was a safe and effective treatment that significantly reduced the need for surgery and shortened hospitalization