Pediatric empyema

What is pediatric empyema?

When a child has empyema, pus (fluid filled with immune cells, bacteria and dead cells) pools in the area between the lungs and the inner surface of the chest wall – known as the pleural space.

When a child has pus that gathers in the pleural space, they can’t cough it out. Therefore, it must be drained using a needle or surgical procedure.

What are the different types of pediatric empyema?

There are two types of empyema:

1. Simple empyema - When a child first develops empyema, it is known as simple empyema. In this stage of the condition, the pus is free flowing.
2. Complex empyema - When a child has had empyema for a period of time and it has advanced, it is known as complex empyema. The inflammation is more severe, and scar tissue may have formed within the chest cavity. With complex empyema, a thick peel over the pleural space – known as a pleural peel – may develop. When this peel is present, breathing is limited because the lungs cannot expand.

What are the signs and symptoms of pediatric empyema?

Symptoms of simple empyema:

• Chest pain that worsens when breathing
• Confusion
• Decreased appetite
• Dry cough
• Fever
• Headache
• Increased sweating
• Shortness of breath

Symptoms of complex empyema:

• Chest pain
• Trouble breathing
• Weak breath sounds
• Unexplained weight loss

What are the causes of pediatric empyema?

Your child is at an increased risk to develop post-pneumonia empyema if they also have:

• Abscess of the lung
• Bronchiectasis
• Chronic obstructive pulmonary disorder (COPD)
• Compromised immune system
• Diabetes
• Recent traumatic injury
• Rheumatoid arthritis
• Surgery

In most cases, empyema develops after a child has had pneumonia.