skip to main content

Empyema — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRespiratoryEmpyemaRACP Paediatrics

A 4-year-old boy presents to the emergency department with a 4-day history of high fever, cough, and right-sided chest pain. Chest X-ray shows a right-sided pleural effusion. Ultrasound confirms a moderate effusion with septations. CRP is 250 mg/L. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — IV antibiotics and chest drain insertion

A moderate-to-large septated parapneumonic effusion/empyema in a child with ongoing sepsis requires drainage. The RCH Melbourne guidelines recommend insertion of a chest drain (pigtail catheter or surgical drain) with IV antibiotic therapy. Intrapleural fibrinolytics may also be considered for septated collections. Observation alone risks delayed recovery.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Pneumonia