ABSTRACT
The overall anatomy and physiology of the pleural space in children is the same as in adults.1 Many of the past reports of pediatric pleural effusions have been retrospective and include small numbers of patients and data from adult studies were extrapolated to pediatrics. However, several recent studies highlight the differences in pediatric and adult patients with pleural disease.2 Not only is the differential diagnosis of pediatric pleural effusions different from that for adults, but pediatric co-morbid conditions are different which likely influences outcomes. For example, a prospective study of fibrinolytic therapy for parapneumonic effusions in adults concluded no benefit3
while a study of pediatric patients suggested advantages to fibrinolytic therapy.4 In 2005, The British Thoracic Society (BTS) published the first pediatric specific guidelines for the management of pleural infection children.5 While this is a very useful document and provides an extensive review of the literature, the authors highlight the need for additional pediatric data.
