فهرست نشریات علمی دسترسی آزاد ایران

Abstract:  Background: Empyema thoracis, the accumulation of purulent fluid in the pleural cavity, remains a significant cause of pediatric morbidity in developing regions despite global advancements in treatment. This study examines the epidemiology, clinical presentation, microbiological profile, and therapeutic outcomes of pediatric empyema in Baghdad, Iraq, providing comparative insights with regional and international data.  Methods: A retrospective cohort analysis was conducted across three tertiary care centers in Baghdad—Ghazi Al-Hariri Surgical Specialties Hospital/Medical City, Ibn al-Nafees Hospital, and Al-Imamain Al-Kadhmian Medical City—from January 2022 to December 2023. Patients were stratified into uncomplicated and complicated empyema groups based on clinical and radiological criteria.  Results: Among 50 pediatric cases (62% male, 38% female; ratio 1.6:1), the predominant age group was 1–5 years (46%). Universal fever (100%), dyspnea (84%), and cough (76%) were the most frequent symptoms, with bronchopneumonia as the leading predisposing factor (32%). Microbiological analysis identified pleural fluid pathogens in 38% of cases, predominantly Streptococcus pneumoniae (16%) and Staphylococcus aureus (14%). Complications included pyopneumothorax (26%) and pneumothorax (8%). Tube thoracostomy with antibiotics achieved treatment success in 90% of patients, while 10% required surgical decortication. Seventy percent of cases had hospital stays under 14 days.  Conclusion:   Pediatric empyema in Baghdad exhibits distinct characteristics, including delayed presentation, high complication rates, and a unique microbiological profile. The 90% efficacy of tube thoracostomy supports its role as a first-line, resource-adapted therapy in comparable settings. These findings underscore the need for tailored management protocols in high-burden regions.