Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 27:13:1547146.
doi: 10.3389/fped.2025.1547146. eCollection 2025.

Immunological dysfunction of children with severe parapneumonic effusion

Barnabás Rózsai  1 , Diána Simon  2 , Tímea Berki  2 , Gabriella Kiss  1 , Bernadett Mosdósi  1
Affiliations

Immunological dysfunction of children with severe parapneumonic effusion

Barnabás Rózsai et al. Front Pediatr. .

Abstract

Purpose: Despite the worldwide decrease in the incidence of serious pneumococcal infections following the introduction of the 13-valent pneumococcal conjugate vaccines (PCV13), invasive infections still occur. This study aimed to investigate the immunological function of children with severe parapneumonic effusion (PPE) both during their hospitalization and after full recovery.

Methods: This was a prospective, single-center study. Children with PPE were admitted to our clinic between 1 January 2011 and 30 June 2023, and participated in the study. Due to the severity of the effusion, all PPE cases required thoracic drainage and some children also underwent fibrinolysis and/or video-assisted thoracoscopic surgery. Demographic and clinical data and laboratory results were collected at admission. Extended immunological testing was performed at the time of clinical admission and again 6-8 weeks after discharge.

Results: A total of 66 episodes of PPE were identified. During hospitalization, one patient was diagnosed with human immunodeficiency virus infection and another with immunoglobulin A deficiency. Extended immunological evaluation was performed during follow-up in 49 patients. Within this cohort, seven patients were diagnosed with mannose-binding lectin deficiency and three with specific antibody deficiency. In total, immune dysfunction was confirmed in 12 patients. When comparing the immunocompromised and non-immunocompromised groups, the duration of hospitalization was longer in the immunocompromised group, with no other differences observed.

Conclusion: Although the incidence of severe PPE has declined since the introduction of PCV13, immunological evaluation remains essential for identifying underlying immunodeficiencies. Despite vaccination, screening patients with PPE for immune dysfunction is crucial. Early diagnosis and timely treatment can help prevent organ damage and reduce long-term morbidity.

Keywords: children; community-acquired pneumonia; immunodeficiency; parapneumonic effusion; pneumococcal conjugate vaccine.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Similar articles

See all similar articles

References

    1. Efrati O, Barak A. Pleural effusions in the pediatric population. Pediatr Rev. (2002) 23(12):417–26. 10.1542/pir.23.12.417 - DOI - PubMed
    1. de Benedictis FM, Kerem E, Chang AB, Colin AA, Zar HJ, Bush A. Complicated pneumonia in children. Lancet. (2020) 396(10253):786–98. 10.1016/S0140-6736(20)31550-6 - DOI - PubMed
    1. Zemlicková H, Urbásková P, Adámková V, Motlová J, Lebedová V, Procházka B. Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus isolated from the nasopharynx of healthy children attending day-care centres in the Czech republic. Epidemiol Infect. (2006) 134(6):1179–87. 10.1017/S0950268806006157 - DOI - PMC - PubMed
    1. Tvedskov ESF, Hovmand N, Benfield T, Tinggaard M. Pneumococcal carriage among children in low and lower-middle-income countries: a systematic review. Int J Infect Dis. (2022) 115:1–7. 10.1016/j.ijid.2021.11.021 - DOI - PubMed
    1. Backhaus E, Berg S, Andersson R, Ockborn G, Malmström P, Dahl M, et al. Epidemiology of invasive pneumococcal infections: manifestations, incidence and case fatality rate correlated to age, gender and risk factors. BMC Infect Dis. (2016) 16:367. 10.1186/s12879-016-1648-2 - DOI - PMC - PubMed

LinkOut - more resources