Clinical Profile of Children with Pleural Empyema in Community Acquired Pneumonia: A Cross-sectional Study

Introduction: Empyema as a complication of Community Acquired Pneumonia (CAP) has been reported in a sizeable number of cases. Epidemiological studies on the clinical profile and outcome of CAP with empyema can help in better diagnosis and management of paediatric patients. Aim: To describe the clinical profile of empyema in paediatric patients with CAP attending the tertiary care hospital in Aurangabad, Maharashtra, India. Materials and Methods: The present cross-sectional study was conducted in the Department of Paediatrics at MGM Medical College and Hospital, Aurangabad, Maharashtra, India, from March 2022 to March 2023. Total 82 CAP diagnosed cases of age between two months and 18 years were included. Group A (cases) consisted of 41 cases of CAP with empyema and group B (controls) consisted of 41 cases of CAP without empyema. Data obtained was compiled and compared using unpaired t-test and Chi-square test. Results: The mean age in group A was 76.43±66.15 months and in group B was 45.29±59.19 months. Duration of fever was 8.9±2.84 days in group A and 4.7±0.97 days in group B. The nutritional status of study subjects was malnourished in 29 (70.73%) group A and 21 (51.22%) in group B. The study subjects among the group A were vaccinated for pneumococcal vaccine in 18 (43.9%), and in 29 (70.73%) of the group B. Neutrophil count and C-reactive Protein (CRP) levels were significantly higher, and lymphocyte count was significantly lower in CAP cases with empyema. All the study subjects recovered in the present study; however, the duration of hospitalisation was more in CAP cases with empyema. Conclusion: The number of subjects with malnutrition was more whereas vaccinated with pneumococcal vaccine were less in CAP cases with empyema. High leucocyte, neutrophil counts and raised serum CRP were observed in CAP cases with empyema. Decortication, Video-assisted thoracoscopic surgery and intercostal chest drain insertion were the treatment modalities used in CAP cases with empyema.