Epidemiological, Etiological, Clinical, and Therapeutic Aspects of Pleural Effusion in Children at the Pediatric Department of Libreville University Hospital

Abstract

Objective: This study aimed to improve the management of pediatric pleural effusion at libreville university hospital by identifying primary etiologies and proposing effective diagnostic and therapeutic strategies. Methods: A retrospective, descriptive, and analytical study was conducted from january 2017 to april 2020, including 59 children aged 1 month to 16 years hospitalized for pleural effusion. Data were analyzed using epi-info 7 software. Incomplete records and non-pleural effusion cases were excluded. Results: The prevalence of pediatric pleural effusion was 0.47%, with a male predominance (54.2%) and a peak age range of 1–5 years (50.8%). Common symptoms included fever, cough, and respiratory distress. The most frequent etiologies were staphylococcus aureus (26%) and pleuropulmonary tuberculosis confirmed by genexpert (13.6%). Chest radiographs showed unilateral effusion in 89.7% of cases, while pleural ultrasounds, performed in 62.7% of patients, confirmed effusion in 60.5%. Empirical antibiotic therapy was administered initially and later adjusted based on antibiograms. Patients diagnosed with tuberculosis received a standard antitubercular regimen, including rifampicin, isoniazid, pyrazinamide, and ethambutol. The average hospital stay was 21.6 days, and outcomes were generally favorable. Conclusion: Pediatric pleural effusion is uncommon in gabon, but pleuropulmonary tuberculosis remains a significant cause. Early diagnosis and prompt treatment, including appropriate antimicrobial therapy and standardized antitubercular regimens, are essential to improving outcomes.