Prevalence of Pleural Effusion over Eight Years among Egyptian Children in the Delta region: A Single Center Cross-Section Study.

Background Pleural effusion (PE) is a significant clinical condition characterized by the accumulation of excess fluid in the pleural space, leading to respiratory distress and morbidity. It frequently complicates various pulmonary and systemic disease, including infections, malignancies and cardiac condition. In children, PE is commonly associated with pneumonia and respiratory infections, which remain a leading cause of pediatric morbidity and hospital admission worldwide. Despite its clinical importance, data on the prevalence and etiological factors of PE among pediatric populations in the Egyptian delta region are limited. The current cross-sectional study is a trial to address this gap by evaluating the prevalence and clinical phenotyping of PE in children admitted to a tertiary care center in delta region over an eight-year period. Understanding the epidemiology and underlying factors of PE in this setting is crucial for improving diagnosis, management and outcomes among affected children. Methods A cross-sectional study was conducted at Mansoura University Children’s Hospital (MUCH), Egypt, from January 2016 to December 2023. All admissions aged 2 months to 18 years (n = 19,411) were reviewed to identify cases of PE, PPE, and pneumonia for prevalence and phenotype analysis. Results The prevalence of Pleural effusion was 0.82% within this cohort, with infectious causes accounting for 83.13%. Pneumonia prevalence was 3.4% and parapneumonic effusion occurred in 19.96% in pneumonia cases. Clinical phenotyping revealed that the most common age group was 2–6 years (44.4%), with a male predominance (63.7%). Fever was present in 92.5% of cases, while abdominal symptoms occurred in 6.3%. The most frequent complication was loculation, observed in 13.8%. Staphylococcus coagulase-positive species were the primary isolates, found in 15.8% of pleural cultures and 14.4% of blood cultures. Radiological findings showed lobar consolidation in 43.8% of cases. None of the studied cases had received pneumococcal vaccination. In conclusion: This study highlights regional epidemiological patterns that differ from Western cohorts, emphasizing the clinical significance of Staphylococcus and the morbidity burden associated with delayed care among children in Egypt’s Delta-region. These findings underscore the urgent need to strengthen pneumococcal vaccination programs, enhance diagnostic infrastructure, and develop context-appropriate antimicrobial guidelines for resource-limited settings.