{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T16:58:57Z","timestamp":1772729937989,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>As pleural inflammation plays a central role in pleural infection (PI), corticosteroids are increasingly being considered as a potential therapy. However, the timing of treatment and the identification of patients who might benefit most remain unresolved. The aim of this study was therefore to investigate the inflammatory trajectories of children with PI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective single\u2010center study included children aged 3 months to 17 years and 11 months hospitalized for PI due to <jats:italic>Streptococcus pyogenes<\/jats:italic>, <jats:italic>Streptococcus pneumonia<\/jats:italic>, and <jats:italic>Staphylococcus aureus<\/jats:italic> over 10 years. An inflammatory rebound was defined biologically as a reincrease in C\u2010reactive protein (CRP) of at least 50\u2009mg\/L after an initial decrease in CRP of at least 50\u2009mg\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 53 cases of PI, including 16 due to <jats:italic>S. pyogenes<\/jats:italic>, 27 due to <jats:italic>S. pneumonia<\/jats:italic>, and 10 due to <jats:italic>S. aureus<\/jats:italic>. An inflammatory rebound occurred in 20 patients (38%) after a median of 4.5 (3\u22126) days. This inflammatory rebound occurred in 9 (56%) children with <jats:italic>S. pyogenes<\/jats:italic>, 8 (30%) children with <jats:italic>S. pneumonia<\/jats:italic>, and 3 (30%) children with <jats:italic>S. aureus<\/jats:italic>. Children with an inflammatory rebound also had a higher rate of persistent fever after Day 7 and a longer length of stay (<jats:italic>p<\/jats:italic>\u2009=\u2009.01 for both).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We postulate that the inflammatory rebound identified in nearly 40% of our patients corresponds to an early postinfectious inflammatory response, and thus that corticosteroids may be most beneficial for children with PI if administered early (between Days 2 and 5).<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26859","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T14:18:36Z","timestamp":1704982716000},"page":"974-981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inflammatory rebound and postinfectious inflammatory response in children with pleural infection: A single\u2010center retrospective study"],"prefix":"10.1002","volume":"59","author":[{"given":"Cl\u00e9ment","family":"Poirault","sequence":"first","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7451-9890","authenticated-orcid":false,"given":"Alice","family":"Hadchouel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Schmartz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apolline","family":"Gonsard","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Garcelon","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 Paris France"},{"name":"Institut Imagine Paris France"},{"name":"INSERM, Centre de Recherche des Cordeliers UMR 1138 Equipe 22 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-7150","authenticated-orcid":false,"given":"Christophe","family":"Delacourt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7324-4992","authenticated-orcid":false,"given":"David","family":"Drummond","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology and Allergology University Hospital Necker\u2010Enfants Malades, AP\u2010HP Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9 Paris France"},{"name":"Inserm UMR 1138, HeKA team Centre de Recherche des Cordeliers Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2022-219784"},{"key":"e_1_2_11_3_1","unstructured":"The BTS Pleural Guideline Development Group. 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