Pleural effusion in a pediatric ward: clinical feature, etiology and outcome

Abstract

Background: Pleural effusion is a common respiratory complication in children. We aimed to document clinical feature, etiology, biochemical parameters and outcome of the admitted children with pleural effusion.

Methods: This cross-sectional study was conducted from January 2022 to June 2023 at pediatric ward of ICMH. All children from 6 months to 14 years presented with clinical features suggestive of pleural effusion and later supported by radiology and ultrasonography of chest either at presentation or owing to other systemic illness were enrolled. Children aged below 6 months, associated chronic illness and parental denial of giving consent were excluded. In indicated cases pleural fluid was tapped and sent to laboratory for physical, biochemical examination, staining, culture, GeneXpert, LDH and ADA assay.   

Results: Out of 43 children, 19 underwent pleural tap and rest were managed conservatively. Most of the children were in between 2 to 6 years. There were 22 male and 21 female. Unilateral effusion was found in 25 children and 18 children developed bilateral effusion. All the children had documented fever. Other symptoms were cough, respiratory distress, chest pain, weight loss, abdominal pain, jaundice and blood mixed sputum. Physical signs correlated classical effusion features. The etiologies included DF, TB, para-pneumonic effusion, empyema, nephrotic syndrome, malignancy, acute viral hepatitis, heart failure and acute pancreatitis. There was no mortality and long-term complication in non-malignant cases.

Conclusions: DF outnumbered other causes of pleural effusion in recent times owing to recent Dengue outbreak. Tubercular effusion was leading cause among cases undergoing pleural tap.