{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T21:53:01Z","timestamp":1788126781185,"version":"build-2803163510"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bern"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Paediatric parapneumonic effusion (PPE) is accompanied by an increased risk of complications, e.g., sepsis or lung sequelae. Treatment strategies span from antibiotics alone to surgical interventions, but an internationally accepted guideline is lacking. With this study, we aim to better understand how management strategies influence short-term outcome parameters, like length of stay, antibiotic treatment duration, and lung damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective observational single-centre study. Patients admitted from 1 July 2004 to 30 June 2024 with PPE to our tertiary hospital were analysed. We used the exact Jonckheere-Terpstra test to analyse trends over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 278 patients were included, 23 (8%) had to be excluded for lack of informed consent. A majority (173\/255, 68%) were treated with pleural drainage. Over time, drains were increasingly more often inserted without surgery, 20% vs. 65% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) in 2004\u20132008 vs. 2020\u20132024. Intravenous antibiotic treatment duration declined from 15 days in 2004\u20132008 to 11 days in 2020\u20132024,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002. The most commonly identified pathogen was\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      (39%), followed by\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      (18%).\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      compared to\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      was more often associated with sepsis or toxic shock (45% vs. 6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), but fewer patients showed radiologic evidence for acute lung damage (68% vs. 23%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      We found considerable clinical differences in patients with PPE caused by\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      vs.\n                      <jats:italic>S. pyogenes.<\/jats:italic>\n                      The former was associated with substantially greater lung damage.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-025-02662-1","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T15:26:28Z","timestamp":1760455588000},"page":"287-297","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Paediatric parapneumonic effusion \u2013 a twenty-year clinical narrative"],"prefix":"10.1007","volume":"54","author":[{"given":"Leonie","family":"Bregy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp K.A.","family":"Agyeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Duppenthaler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Kieninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Juzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Cholewa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Casaulta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias V.","family":"Kopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Aebi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5240-5016","authenticated-orcid":false,"given":"Nina","family":"Sch\u00f6bi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"2662_CR1","doi-asserted-by":"publisher","unstructured":"Li S-TT, Tancredi DJ. 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Approval was granted by the Ethics Committee of the University of Bern (Project-ID 2023\u2009\u2212\u200900837).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed general consent for the use of routine clinical patient data was given by the legal guardians of all patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}