{"id":9,"date":"2007-07-11T20:00:55","date_gmt":"2007-07-11T19:00:55","guid":{"rendered":"http:\/\/resource.bmj.com\/adc-archimedes\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/"},"modified":"2007-07-11T20:00:55","modified_gmt":"2007-07-11T19:00:55","slug":"what-is-the-best-treatment-for-empyema","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/","title":{"rendered":"What is the best treatment for empyema?"},"content":{"rendered":"<p>A 7 year old child with a history of cough and fever for 1 week, has bronchial breathing over her left lower zone on auscultation. A diagnosis of lobar pneumonia is made, confirmed on plain chest x-ray, and she is treated with appropriate intravenous antibiotics. However, she continues to have a spiking fever and develops signs of a left sided pleural effusion. Repeat chest x-ray shows a \u2018white out\u2019 of the left chest with no mediastinal shift.  She is referred to the regional thoracic centre for consideration of thoracotomy and drainage of a left sided parapneumonic effusion. Should she be referred to the surgeons and if so, what should they do?<\/p>\n<p><!--more--><\/p>\n<p><strong>Clinical Bottom Line<\/strong><\/p>\n<p>There is no evidence to support a better clinical outcome from VATS compared to a chest drain with intrapleural fibrinolytic in children with empyema. Most children will do well with this therapy alone.  [Grade B]<\/p>\n<p><a href=\"http:\/\/adc.bmj.com\/cgi\/rapidpdf\/adc.2007.127373v1\/?archiblog\" title=\"Archimedes Report\">Read more<\/a><\/p>\n<p><u> <\/u><strong>Authors<\/strong><\/p>\n<p>Orlena Kerek (Respiratory Registrar, Bristol  Royal Hospital for Children) [orlenakerek@yahoo.com]<\/p>\n<p>Tom Hilliard, Paediatric Respiratory Consultant, Bristol  Royal Hospital for Children<\/p>\n<p>John Henderson, Reader in Paediatric Respiratory Medicine, University  of Bristol<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 7 year old child with a history of cough and fever for 1 week, has bronchial breathing over her left lower zone on auscultation. A diagnosis of lobar pneumonia is made, confirmed on plain chest x-ray, and she is treated with appropriate intravenous antibiotics. However, she continues to have a spiking fever and develops [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2007\/07\/11\/what-is-the-best-treatment-for-empyema\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[153,215,86,82,87],"tags":[],"class_list":["post-9","post","type-post","status-publish","format-standard","hentry","category-answered","category-empyema","category-fibrinolytics","category-therapy","category-vats"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/9","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=9"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/9\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=9"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=9"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=9"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}