STAPHYLOCOCCAL PNEUMONIA IN CHILDHOOD - WILL EARLY SURGICAL INTERVENTION LOWER MORTALITY

Staphylococcus aureus pneumonia (SAP) continues to be a serious bacter ial infection which is associated with a high incidence of complicatio ns. We retrospectively reviewed the case records of 36 infants and chi ldren admitted with SAP to the Sophia Children's Hospital between 1970 and 1992 to analyse changes over time in the clinical presentation, d iagnostic work-up, management and complications. Fifteen of these 36 c hildren (42%) were less than 1 year old. Fever (97%) and respiratory d istress (83%) were the most common symptoms at the initial presentatio n. Chest X-ray findings on admission or during hospitalisation include d pleural effusion (75%), pneumothorax (47%), and abscess and/or pneum atocele (39%). Diagnostic and/or therapeutic thoracentesis of pleural fluid was performed in 17 of the 36 patients (47%). Twenty-one patient s (58%) needed chest tube drainage. Twelve had a thoracotomy (33%). Ar tificial ventilation was needed in 13 of the patients (36%). Extrapulm onary complications included convulsions in 6 patients (17%) and osteo myelitis in 2 children (6%). The mean duration of hospitalization was 36 days. Two of the 36 children died (6%). The low mortality rate in t his study may be the result of the relatively high rate of thoracotomy and of improvements in supportive treatment. (C) 1995 Wiley-Liss, Inc .