Intrapleural Streptokinase in Parapneumonic / Complicated Pleural Effusion/Empyema: Experience in Dhaka Shishu (Children) Hospital

Authors

  • Md Shakibur Rahman FCPS part II trainee, Department of Pediatric Respiratory Medicine, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
  • Probir Kumar Sarkar Associate Professor, Department of Pediatric Respiratory Medicine, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
  • Khandakar Ashikur Zaman Medical Officer, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
  • Nabila Akand Registarar, Department of Pediatric Respiratory Medicine, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
  • - Md Kamruzzaman Assistant Professor, Department of Pediatric Respiratory Medicine, Bangladesh Institute of Child Health (BICH) and Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjch.v44i2.51135

Keywords:

parapneumonic effusion/complicated pleural effusion/empyema

Abstract

Background: Parapneumonic effusion/complicated pleural effusion/empyema thoracis in children causes significant morbidity. Standard treatment of pleural effusion includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis as well as complicated pleural effusion with good success rate. Though its efficacy is documented in Western literatures and textbooks, there are no clinical trials in children has been reported from Bangladesh.

Objectives: We evaluated the efficacy of intra-pleural Streptokinase in the management of Parapneumonic effusion / complicated pleural effusion/ empyema thoracis even in advanced stages.

Patients and Methods: A total of 3 patients with parapneumonic effusion requiring intercostal tube drainage, aged 4 year 6 month to twelve years were included in the study who were admitted in Pediatric respiratory medicine unit in Dhaka Shishu (Children) Hospital. Intercostal chest tube drain was given in all patients and inj: Streptokinase (10,000 units/kg/dose) was instilled into the pleural cavity and kept the Streptokinase for 4 hour in pleural cavity. Response was assessed by clinical outcome, after unclamping and serial chest ultrasounds and subsequent chest radiography.

Results: Streptokinase enhanced drainage of pleural fluid and complete resolution of effusion in all the 3 patients.

Conclusions: Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema/parapneumonic effusion/complicated pleural effusion even in advanced stages and can avoid surgery.

Bangladesh J Child Health 2020; VOL 44 (2) :104-108

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Published

2020-12-31

How to Cite

Rahman, M. S., Sarkar, P. K., Zaman, K. A., Akand, N., & Md Kamruzzaman, .-. (2020). Intrapleural Streptokinase in Parapneumonic / Complicated Pleural Effusion/Empyema: Experience in Dhaka Shishu (Children) Hospital. Bangladesh Journal of Child Health, 44(2), 104–108. https://doi.org/10.3329/bjch.v44i2.51135

Issue

Section

Case Reports