{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:48:51Z","timestamp":1784249331402,"version":"3.55.0"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The clinical data of a child with complex parapneumonic effusion (PPE) caused by pneumofluke infection were analyzed, and the diagnosis and treatment of the disease were discussed through literature review. The effectiveness and safety of urokinase in the treatment of complex PPE and empyema caused by multiple pathogens were emphasized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 3-year-old male child with pneumofluke infection was admitted to the pediatric department of Mianyang Central Hospital. Chest CT and chest ultrasound showed a right pleural effusion with dense septum formation. The condition was relieved after treatment with praziquantel for anti-infection, thoracic catheter drainage, and urokinase injection into pleural cavity. Through systematic literature search of Pubmed, Embase, CNKI, Wanfang and VIP Chinese databases, no cases of urokinase treatment of pleural effusion caused by pneumofluke infection were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 150\u2005ml thick yellow turbidous fluid was drained out of the pleural cavity, and the patient's symptoms and signs were significantly relieved. Reexamination of the chest CT showed that the right pleural effusion was significantly reduced and the right lung was significantly reexpanded. There were no complications such as bronchopleural fistula, pneumothorax, abnormal coagulation function, bleeding and fever during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thoracic catheter drainage combined with injection of urokinase is an effective and safe method for the treatment of complex PPE and empyema caused by pneumofluke infection in children. At the same time, the literature review showed that urokinase injection into pleural cavity was effective in the treatment of complex PPE and empyema caused by infection, trauma, tumor and other causes, and no obvious side effects occurred.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1557273","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T05:29:37Z","timestamp":1749101377000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A case of complicated parapneumonic pleural effusion caused by paragonimus infection in a child was successfully treated by intrapleural injection of urokinase: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Yangyi","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"B1","first-page":"1","volume-title":"Diagnosis of Paragonimiasis: WS 380-2012","year":"2012"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1093\/cid\/cir531","article-title":"The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the pediatric infectious diseases society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin Infect Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e63","DOI":"10.1542\/peds.103.5.e63","article-title":"Early video-assisted thoracic surgery in the management of empyema","volume":"103","author":"Grewal","year":"1999","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1136\/thx.2004.030676","article-title":"BTS guidelines for the management of pleural infection in children","volume":"60","author":"Balfour-Lynn","year":"2005","journal-title":"Thorax"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1016\/j.radcr.2022.02.046","article-title":"Paragonimiasis diagnosed by CT-guided transthoracic lung biopsy: literature review and case report","volume":"17","author":"Cong","year":"2022","journal-title":"Radiol Case Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/978-3-030-18616-6_5","article-title":"Paragonimiasis","volume":"1154","author":"Blair","year":"2019","journal-title":"Adv Exp Med Biol"},{"key":"B7","first-page":"5","article-title":"Analysis of clinical misdiagnosis of pulmonary paragonimiasis","volume":"36","author":"Xie","year":"2023","journal-title":"Clin Misdiagnosis Mistreatment"},{"key":"B8","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3904\/kjim.2015.30.1.56","article-title":"Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis","volume":"30","author":"Hwang","year":"2015","journal-title":"Korean J Intern Med"},{"key":"B9","first-page":"1080","article-title":"Chinese expert consensus on the diagnosis of pleural effusion","volume":"45","year":"2022","journal-title":"Chin J Tuberc Respir"},{"key":"B10","doi-asserted-by":"publisher","first-page":"212","DOI":"10.4329\/wjr.v9.i4.212","article-title":"Computed tomography-guided catheter drainage with urokinase and ozone in management of empyema","volume":"9","author":"Li","year":"2017","journal-title":"World J Radiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00408-016-9964-2","article-title":"Manual intrapleural saline flushing plus urokinase: a potentially useful therapy for complicated parapneumonic effusions and empyemas","volume":"195","author":"Porcel","year":"2017","journal-title":"Lung"},{"key":"B12","doi-asserted-by":"publisher","first-page":"145","DOI":"10.4103\/atm.atm_14_22","article-title":"Fibrinolysis versus thoracoscopy: comparison of results in empyema management in the child","volume":"17","author":"Ibarra Rodr\u00edguez","year":"2022","journal-title":"Ann Thorac Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.jpedsurg.2017.07.017","article-title":"Evolution of practice in the management of parapneumonic effusion and empyema in children","volume":"53","author":"Griffith","year":"2018","journal-title":"J Pediatr Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.anpedi.2011.05.014","article-title":"Tratamiento del empiema paraneum\u00f3nico tabicado: \u00bfvideotoracoscopia o fibrinol\u00edticos? 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