Abstract

Although is decreasing the incidence of pneumonia in childhood, the incidence of parapneumonic effusion and empyema has increased in the past decade. These complications can occur in 28-53% of pediatric pneumonia. The diagnosis of empyema can be identified by the examination of pleural fluid with biochemical and microbiological studies and radiological demonstrations of fibrin accumulation in pleural space. Therefore, the diagnosis and stage of the empyema can be achieved and treatment strategy can be decided. The goal of the treatment in empyema is to evacuate the fibrin and debris from the pleural cavity to expand the lung without entrapment. The treatment strategies antibiotherapy, drainage with thoracentesis or tube thoracostomy, thoracoscopic debridement, fibrinolytic therapy or decortication with thoracotomy should be decided according to the stage of the disease. In this review, we aimed to report the minimal invassive approach in thoracic empyema with the evaluation of current management strategies in children.