Intrapleural fibrinolytic therapy in a neonate.

Pleural effusions are common complications of pediatric bacterial pneumonias. Failure to control the pleural effusions may lead to progressive disease and can result in complicated parapneumonic effusions. The natural history of a complicated parapneumonic effusion is to develop a single loculus or multiple loculations and then progress to an empyema cavity in untreated or inadequately treated patients. Simple chest tube drainage is often inadequate in complicated parapneumonic effusions, due to the presence of viscous fluid with fibrinous debris clogging the tube ormultiple loculations in the pleural space.