Parapneumonic effusions occur as a complication of community-acquired pneumonia and are a common cause for hospital admission in children. New imaging techniques, particularly ultrasound, have helped in planning the management of children with parapneumonic effusion. In this study, the association between ultrasonographic staging, biochemical features of pleural fluid and therapeutic approach were evaluated retrospectively. Five patients were assessed as stage I, 15 patients as stage II, 12 patients as stage IIIa, and 15 patients as stage IIIb according to the appearances of parapneumonic effusions on ultrasound. All patients in stage I, seven patients in stage II, and one patient in stage IIIa were treated with intravenous broad-spectrum antibiotics alone. Closed tube drainage was performed in 33 patients. Ultrasonographic staging of pleural fluid pH and glucose levels, bacteriologic evidence and treatment methods were compared. For ultrasonographic stage I, IIIa, and IIIb, biochemical criteria and suggested treatment were found suitable. But as half of the stage II patients who shared biochemical findings of simple parapneumonic effusion and complicated parapneumonic effusion, different treatment methods were used. Successful tube thoracostomy drainage was achieved in 28 of these patients; failure of tube thoracostomy drainage occurred in five patients. In conclusion, ultrasound seems to be an effective method of assessing disease severity and planning treatment. Appropriate antibiotic therapy and tube thoracostomy drainage are effective in most children with complicated parapneumonic effusions.

Keywords: parapnömonik efüzyon, ultrasonografi, plevral ampiyem, tüp torakostomi, parapneumonic effusions, ultrasonography, pleural empyema, tube thoracostomy