A Study of Clinico-Etiological Profiles and Outcomes of Pleural Effusion in a Tertiary Care Hospital.

BACKGROUND

Pleural effusion in children is an important cause of respiratory morbidity with diverse infective and non-infective etiologies. Clinical presentation, biochemical profile, microbiological findings, and imaging characteristics play a major role in determining etiology, severity, treatment strategy, and overall outcome in pediatric pleural effusion.

OBJECTIVES

The study aimed to evaluate the clinico-etiological profile and outcomes of pleural effusion in children admitted to a tertiary care hospital.

METHODS

This cross-sectional study was conducted in the pediatric ICU and pediatric ward of Dr. Susheela Tiwari Hospital, Government Medical College, Haldwani, India. Eighty children with pleural effusion were enrolled. Clinical examination, hematological investigations, pleural fluid analysis, adenosine deaminase (ADA) estimation, cartridge-based nucleic acid amplification test (CBNAAT), microbiological studies, chest radiography, and ultrasonography were performed.

RESULTS

Tubercular pleural effusion was the commonest etiology (36, 45.0%), followed by parapneumonic effusion (18, 22.5%) and empyema thoracis (11, 13.75%). Fever (62, 77.5%), cough (68, 85.0%), and respiratory distress (54, 67.5%) were predominant symptoms. Exudative effusion was observed in 68 (85.0%) patients. Pleural ADA was significantly higher in tubercular effusion (84 ± 22 IU/L; p < 0.001). Intercostal drain (ICD) insertion, ultrasonographic loculation, and tubercular etiology independently predicted prolonged hospitalization.

CONCLUSION

Infective etiologies, particularly tuberculosis and parapneumonic infection, constituted the major causes of pediatric pleural effusion. Combined clinical, radiological, biochemical, and microbiological assessment significantly improved etiological diagnosis. Pleural fluid ADA demonstrated good diagnostic utility for tubercular pleural effusion. Early identification of complicated disease and timely intervention contributed to favorable clinical outcomes and low mortality.