Staphylococcal lower respiratory infection in children.

A prospective study of staphylococcal lower respiratory infection in 31 children aged 1-48 months has shown that radiologically, patchy consolidation was the single most common lesion, followed by pleural effusion with or without pneumothorax. Although the mean respiratory rate was 65/minute, it was below 50/minute in 8 cases. Complications include heart failure in 9 cases and severe anaemia necessitating blood transfusion in 9 others, seven (78%) of whom had pleural effusion. Finally diagnoses were bronchopneumonia alone in 16 (52%) cases, pyopneumothorax alone in 6 (19%), pyopneumothorax plus pneumonia in 5 (16%), pleural effusion in 2 (6%) cases and one case each of lobar pneumonia alone and a combination of lobar and bronchopneumonia. Staphylococcus aureus was isolated from the blood in 8 (62%) of 13 children with pleural effusion, indicating a need to consider parenteral antibiotic administration in the initial management of children with staphylococcal pleural effusion. Three (9.7%) patients died; they were all malnourished children who did not receive antibiotics prior to presentation; they all had bronchopneumonia, positive blood cultures and respiratory rates of 60/minute.