Article in Japanese

A case of empyema in a girl with severe motor and developmental disabilities

Eisuke INAGE^1,2), Asuka ISHIDA¹⁾, Hiroshi TAKAYASU¹⁾, Mitsutaka KOMATSU¹⁾, Tomoyo MATSUBARA¹⁾, Kaoru OBINATA¹⁾, Toshiaki SHIMIZU²⁾

The number of children with empyema has dramatically decreased in the past decades. However, empyema with some co-morbidity, such as severe motor and developmental disabilities, is an emerging problem in Japan. Here, we reported on a case of bacterial empyema. A 5-year-old girl with severe cerebral palsy was admitted to our hospital because of chronic cough for one month and persistent fever for 4 days. Decreased breath sounds and bilateral coarse crackle were audible together with a dull percussion note over the left thoracic wall.
Leukocytosis and elevation of C-reactive protein were observed. Left empyema was diagnosed by chest X-ray and CT. The patient was successfully treated with chest drainage and intrathoracic urokinase injection. Because constituents of oral flora were cultured from the thoracic effusion, aspiration was suspected as a cause of empyema. We reviewed the management of bacterial empyema.

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1) Department of Pediatrics, Juntendo University, Urayasu Hospital
2) Department of Pediatrics and adolescent medicine, Juntendo University School of Medicine

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Received	February 5, 2010
Accepted	June 14, 2010

22 (3)：227─232,2010