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J Trop Pediatr. 2019 Jun 16. pii: fmz036. doi: 10.1093/tropej/fmz036. [Epub ahead of print]

Pleural Thickening after Pleural Effusion: How can we Follow-Up in Children?

Author information

1
Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey.
2
Department of Pediatric Pulmonology, Dr Sami Ulus Maternity and Children Research and Training Hospital, 06080 Ankara, Turkey.
3
Department of Pediatric Infectious Disease, Gazi University Faculty of Medicine, Ankara, Turkey.
4
Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.
5
Department of Medical Education, Gazi University Medicine Faculty, Ankara, Turkey.

Abstract

INTRODUCTION:

No clear information exists about the factors affecting pleural thickening following parapneumonic effusion in children. We aimed to investigate factors that affect the resolving time of pleural thickening after parapneumonic effusion.

METHODS:

Between the years of 2007-18, 91 patients, which were followed due to diagnosis of pleural thickening after parapneumonic effusion, were assessed. Ages, complaints, physical examination findings, laboratory results, chest x-ray and ultrasonography findings, treatments, duration of treatment and recovery time of the patients were examined terms in of pleural thickening resolving time.

RESULTS:

The mean age of patients was 7.5 ± 5.0 years. Pleural thickening resolving time was 151 ± 6.8 days. The resolving time for pleural thickening was delayed with older ages, longer duration of complaints, fever before hospital admission and treatment, lower oxygen saturation at the time of admission, crackles in the physical examination, higher white blood cell count and pleural fluid density (p = 0.018, p = 0.001, p = 0.021, p = 0.020, p = 0.024, p = 0.025, p = 0.021, p = 0.019). In addition, the amount of effusion measured by thorax ultrasonography, fibrinolytic usage, and complications had a role in the delayed resolving time (p = 0.034, p = 0.001, p = 0.034). Pleural thickening resolved in 80% of the patients.

CONCLUSION:

In this report, 80% of pleural thickening, following parapneumonic effusion resolved within 5 months. Patients who do not have a complication during follow-up are not required to monitor with frequent chest x-ray. Patients with a higher amount of pleural effusion, complications and need for fibrinolytic treatment should be followed more carefully.

KEYWORDS:

children; follow-up; parapneumonic effusion; pleural thickening

PMID:
31204435
DOI:
10.1093/tropej/fmz036

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