Text Box: EMPYEMA THORACIS IN HOSPITALIZED CHILDREN IN ALEXANDRIA, EGYPT Hussein Z 1, Eissa M 1, El-Gharbawy M2, and Eldosoky A1. 1 Pediatric Department, Alexandria University, Alexandria, Egypt. 2 Microbiology Department, Alexandria University, Alexandria, Egypt Objectives: To assess the etiology, course, way of management and the complications encountered in empyema cases treated in Alexandria University Children’s Hospital. Methods: The following were done for 30 cases of empyema: Complete blood picture, tuberculin testing, blood culture and aspiration of the pleural fluid. Aspirated fluid was subjected to gram staining, culture and latex agglutination testing. Patients were treated with a combination of intravenous antibiotics and chest tube drainage. Results: Ninety percent of cases had leukocytosis above 10,000 /mm3. Blood cultures were positive in only 6.7% of cases. Gram negative bacilli was detected in 16.6% and gram positive diplococci in 6.6% of cases. Culture of pleural fluid revealed Streptococcus pneumoniae (Strp.p) in 16.7%, ß-haemolytic streptococcus group A (A- ß-h-Strp) in 10%, Haemophilus influenzae(H.i), E-coli, and Proteus in 6.6% each and Klebsiella(K) and Pseudomonas ( Ps) in 3.3% each . No growth was found in 46.7% of cases. Latex test was positive for (Strp.p) in 33.3%, for (H.i) in 16.7%, for (A- ß-h-Strp) in 10% of cases, while 40% of cases were negative. Mean of hospital stay was 13.6 + 2.8 days. Surgical intervention was necessary in only 13.3% of cases. The overall success rate was 86.7%. Conclusion: (Strp.p), (H.i), and (A- ß-h-Strp) are the commonest organisms causing empyema in Alexandria.. Latex test of pleural fluid is a helpful tool in diagnosing patients receiving previous antibiotics. Most bacteria isolated were sensitive to Cefotaxime and Ampicillin. Complications are encountered more in younger age, with delay in chest tube insertion and with empyema caused by gram negative organisms. 1985