Akademik Veri Yönetim Sistemi
Cocuk Enfeksiyon Dergisi, cilt.15, sa.1, 2021 (ESCI)
Objective: Exudative pleural effusion may occur during the course of many infectious and non-infectious diseases, and these diseases should be considered in the differential diagnosis of pleural effusion. In this study, we aimed to emphasize the rare causes and the importance of clinical and laboratory findings in the differential diagnosis of patients hospitalized with a preliminary diagnosis of parapneumonic effu-sion-empyema. Material and Methods: In this study, the data of patients hospitalized with the preliminary diagnosis of parapneumonic effusion-empyema and who were diagnosed as a specific infection such as tuberculosis and parasitic diseases and as pleural effusion due to non-infectious causes in the following days were evaluated retrospectively. Results: Between January 2010 and September 2019, a total of 13 patients [eight males (61.5%), five females (38.5%)], who were admitted with a preliminary diagnosis of parapneumonic effusion and pleural em-pyema, and subsequently received alternative diagnoses, were included in the study. Patients’ complaints on admission were cough, fever, chest pain, abdominal pain, sputum, night sweats, weight loss and respiratory distress, respectively. There was no bacterial growth in blood and pleural fluid cultures of any patients. As a definitive diagnosis, tuberculosis was diagnosed in 5 (38.4%) patients, lymphoma in 4 (30.7%) patients, and hydatid cyst in 4 (30.7%) patients. In one of the patients diagnosed with tuberculosis (20%), Mycobacterium tuberculosis complex was detected by polymerase chain reaction while in 3 (60%) patients by culture. Ma-lignant cells were seen in pleural fluid cytology of 2 (15.4%) patients. In two of the patients, a positive result was obtained by the indirect haem-agglutination test for Echinococcus. Conclusion: Although parapneumonic effusion and empyema are the most important reasons in the etiology of exudative pleural effusion in childhood; tuberculosis, hydatid cyst and malignancy should be considered in pleural effusion that does not improve despite appropriate anti-biotic treatment and drainage.