A case of pleural empyema treated with intrapleuralurokinase

Auteurs-es

  • Federica Xerra Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Immacolata Rulli Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Mauro Iannelli Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Antonella Gambadauro Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Francesca Galletta Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Monica Fusco Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Simona Allera Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Sara Manti Pediatric Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina
  • Carmelo Romeo Pediatric Surgery Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina<strong><br /></strong>
  • Francesco Monaco Thoracic Surgery Unit, Department of Biomedical sciences, Dental and of Morphological and Functional Images, University of Messina, Messina
  • Eloisa Gitto Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina

DOI :

https://doi.org/10.13129/1828-6550/APMB.111.1.2023.CCS2

Mots-clés :

pleural empyema, newborn, intrapleuralurokinase

Résumé

Pleural empyema, a severe complication of bacterial pneumonia, is a rare entity in the neonatal period. Treatment with systemic antibiotics and tube drainage may fail because of the thick viscous fluid, bacterial products with fibrin deposition, and multiple involvement. Intrapleural fibrinolytic therapy with urokinase is an effective and non-invasive treatment option that avoids surgical intervention, although its use in neonates has not been studied extensively. In this report, we describe the case of a 39-day-old male newborn with pneumonia and pleural empyema, treated successfully with antibiotics, chest tube drainage and intrapleuralurokinase.

Références

1. Marhuenda, C., Barceló, C., Fuentes, I. (2014). Urokinase versus VATS for treatment of empyema: a randomized multicenter clinical trial. Pediatrics, 134(5), 1301-1307. doi:10.1542/peds.2013-3935

2. Cha, L.M., Choi, S., Kim, T., Yoon, S.W. (2016). Intrapleuralurokinase therapy in a neonate with pleural empyema. Pediatr Int., 58(7), 616-619. doi:10.1111/ped.12906

3. Saeed Al-Shamrani, A. (2020). Management of Complicated Pneumonia in Children: Evidence Beyond Guidelines. American Journal of Pediatrics. Volume 6, Issue 3, 240-252. doi: 10.11648/j.ajp.20200603.22.

Diez, J.R.V., Perez, M.L.M., Malayan, G.V., Cenabre, M.V.L. (2020). Loculated empyema in a neonate successfully treated with chest tube thoracostomy and antibiotics. Respir Med Case Rep. doi:10.1016/j.rmcr.2020.10127

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Publié

2023-04-11

Numéro

Vol. 111 No. 1 (2023)

Rubrique

CLINICAL CASE SEMINAR

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