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Purpose: This study was done targeting the role of streptokinase injected through pigtail catheter in treatment of pleural empyema in pediatric.Subjects and methods: 15 patients were involved in this study of age ranged from 5 months to 15 years were subjected to STK injection once daily until the drainage don’t exceed 100 ml/day and managed by ultrasound guided insertion of pigtail catheter. Broad spectrum antibiotics were given to all patients, after that the antibiotics were adapted according to result of microbial culture because of failed chest tube drainage intrapleural STK is recommended.Results: 13 cases show significant improvement, as the total amount of fluid before streptokinase injection was 5 cc in average and significantly rose to 220 cc after streptokinase instillation, while 2 cases do not response to this treatment.Conclusion: Imaging guided streptokinase injected through a pigtail catheter provides a powerful protocol for managing of complicated empyema in pediatrics

Imaging guided streptokinase injected through small bore pigtail tail catheter in management of complicated empyema in pediatrics