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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


MACHADO, Karina et al. Features of parapneumonic empyema after the beginning of pneumococcal vaccination: CHPR, 2010. Arch. Pediatr. Urug. [online]. 2014, vol.85, n.4, pp.212-2219. ISSN 1688-1249.

Summary  Parapneumonic empyema (PE) is a frequent and serious complication of community-acquired pneumonia (CAP), mainly caused by Streptococcus pneumoniae. In Uruguay from 2008 were incorporated neumococcal conjugate vaccines (PCV), which resulted in a decrease in the prevalence of pneumococcal disease and changes in the involved serotypes. A descriptive study was conducted to evaluate the characteristics of children less than 14 years hospitalized for PE in 2010. There were identified 69 patients, representing a rate of 63.4/10.000 of the discharges. The average age was 4 years, 37% of children fewer than 5 years had 3 doses of PCV. Initial presentation was severe, with 30% of cases requiring intensive care admission. Chest drain treatment was received by 96%, intrapleural instillation of streptokinase in 64% and surgery in 6%. The hospitalization had an average of 18 days. A significant percentage of children had complications, one died. In 62% of patients, it was identified an etiology, most S. pneumoniae. The serotypes were similar to those identified before implementation of PCV. No vaccine failures were identified. The EP persists as a serious illness; even the PCV implementation determined it decreased prevalence. No significant changes in the serotypes were detected. It is important the continuing monitoring of the PCV implementation effect in this pathology.


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