OPP4 CLINICAL CHARACTERISTICS AND OUTCOMES OF CHILDREN WITH COMPLICATED PNEUMONIA

Nurul Aqilah Ahmad Sukri, Amanil Ula Hassan
Hospital Sultanah Bahiyah, Kedah, Malaysia

Introduction

Complicated pneumonia (CP) presents a significant challenge in pediatric, prompting a detailed exploration of its clinical manifestations and treatment outcomes. It is defined as heterogenous group of pneumonia-related complications including parapneumonic effusion (PPE), empyema, necrotizing pneumonia, abscess and bronchopleural fistula.

Objectives

To review the demographic and clinical characteristics, therapeutic approaches and the outcome of complicated pneumonia in children.

Methodology

This is a single-institution study of pediatric admissions for complicated pneumonia in Hospital Sultanah Bahiyah spanning from July 2022 to June 2024. Database of 24 children were analyzed retrospectively. 

Results

The median age was 49months (range 1-142months). All of them are immunocompetent. Majority 87.5% (21/24) received complete vaccination. Thirteen children (54%) had an exposure to smoking. The median days of illness prior to admission was 5 days (range, 1-14days). Cough is the main presenting complaints 96% (23/24) followed by fever. PPE is the predominant type of CP, 83%. Necrotizing pneumonia was seen in 62.5% (15/24). Ten patients had empyema thoracis confirmed by Ultrasonography and pleural fluid analysis, necessitating chest drainage with median duration of drainage 8.5days (range 5-27days). 7 of them received intrapleural fibrinolysis and 2 had bronchopleural fistula. Blood parameter showed median total white of 13400 (2970-39600/mm3) and CRP of 136 (6-460mg/dL). The median duration of parenteral antibiotics is 26 (7-58days) and length of stay of 29.5days(range 9-72days). Staphylococcus Aureus was identified in 2 pleural fluid samples. 

Conclusion

Complicated pneumonia in children is highly associated with significant morbidity. The clinical course of the disease could be protracted, necessitating extended antibiotic therapy and regular monitoring. Invasive procedures, such as drainage and surgery, were infrequently needed, and most patients achieved complete recovery, highlighting the overall favorable outcomes in pediatric population.