الفهرس 
pleural membranesOnly 14 pages are availabe for public view
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Abstract
Although incidence of empyema in children is relatively low, yet it’s still account an important issue due to its significant morbidity and mortality on affected child. Also debate continues as regard optimum way of management, whether to manage conservatively or surgically from the start The incidence of empyema is approximately 3.3 cases per 100,000 children However recent epidemiologic studies have indicated that empyema has increased in incidence during the last 2 decades with an increase in incidence rate by 2.8% per year from 1987 to 2004. Most case series have reported mortality rates between 7% and 33%.The majority of empyema in children follows acute bacterial lobar pneumonia almost 75%) of cases. Other causes include secondary infection of a traumatic hemothorax or lung contusion, penetrating injury of the chest or after infection in the pleural space following thoracotomy Parapneumonic effusions progress through three stages to an empyema; the first is the exudative stage. If untreated or inappropriately treated, the second or fibropurulent stage evolves. If also untreated or inappropriately treated, the third or organization stage occurs.Symptoms include cough, breathlessness, fever and abdominal pain. Almost all patients present with intermittent pyrexia, tachycardia, and an increased respiratory rate.Some patients will be cyanosed. Clinical signs in the thorax include decreased chest expansion, stony dullness to percussion and reduced or absent breath sounds.