Pneumococcal empyema in childhood
J. D. Siegel, J. C. Gartner and R. H. Michaels
Two serotypes, uncommon in pediatric infections, accounted for a
disproportionately large number of cases of pneumococcal empyema at the
Children's Hospital of Pittsburgh. Eight of ten empyemas were caused by
types 1 or 3, and two additional cases of mixed infection involved the type
3 pneumococcus. The type 3 pneumococcal empyemas tended to be more severe
than those due to other serotypes. Counterimmunoelectrophoresis (CIE)
appeared to be more useful than culture in establishing the cause of this
condition; in seven of ten cases, the pleural fluid was CIE positive while
cultures of blood and pleural fluid were negative. In each of the seven
culture-negative cases, antibiotics had been given prior to
hospitalization. One case of type 7 pneumococcal empyema illustrated the
potential value of the Ouchterlony test for the etiologic diagnosis of this
condition.
