March/April - West Virginia State Medical Association

Scientific Article |
Report of Increased Number of Children with
Parapneumonic Empyema as a Complication of
Bacterial Pneumonia in West Virginia in 2005
Kathyrn Moffett, MD
Associate Professor of Pediatrics
Ann-Marie Tantoco, MD
Internal Medicine/Pediatric Resident
Ohio State University
Introduction
Pediatric invasive disease from
Streptococcus pneumoniae in children
has diminished since the introduction
in 2000 of the heptavalent
pneumococcal conjugate vaccine
(PCV-7 or Prevnar ®) . 1,2 Pediatric
parapneumonic empyema (PPE),
a rare complication of bacterial
pneumonia in children, has been
increasing globally due to nonvaccine
serotype replacements of
S pneumoniae, with serotype 19A
most commonly discovered. 3-20
Recently a similar increase
of parapneumonic empyema
complicating bacterial pneumonia in
2005 was observed in children treated
at the West Virginia University
Children’s Hospital (WVU-CH) in
Morgantown, WV. We conducted
a retrospective review of medical
records from 2000-2007 to determine
the number of children with PPE,
with an attempt to determine the
causative agent(s) and risk factors.
Methods
This study reviewed the medical
records of childhood pneumonia
complicated by parapneumonic
empyema admitted to WVU-CH.
The Institutional Review Board of
West Virginia University reviewed
and approved this retrospective
study. The computerized data
management system was queried
for all cases of parapneumonic
empyema in children less than 18
years of age and for a diagnosis
of pneumonia for the period of
January 2000 to December 2007.
The microbiology data for detection
of viral respiratory specimens
(influenza and respiratory syncytial
viruses) was queried for 2000-
2007. All children with pneumonia
and PPE as a complication of
cardiothoracic surgery, as well as
premature infants with gestational
age