Pleural empyema represents a frequent disease, characterized sometimes by blurred and unspecific signs or symptoms but requiring timely diagnosis in order to plan the most appropriate therapeutic regimen. Several classifications have proposed and the most widely used is the American Thoracic Society (ATS) one, according to increasing severity depending of the extent of disease. Different therap...

Pleural sepsis in children is common in most developing countries. It may present as total pyothorax, pyopneumothorax, or localised thoracic empyema. In most cases, it follows an attack of bronchopneumonia, but other debilitating conditions such as measles, malnutrition, and sickle cell anaemia form part of the clinical syndrome. In a review of 60 cases of pleural sepsis in children aged betwee...

Only few cases of spinal subdural empyema has been reported in the literature and the preoperative diagnosis is much less. Due to the advance of magnetic resonance imaging techniques, we reported a 75 years old female with spinal subdural empyema. She was a diabetic patient and received laminectomy, complicated with vertebral body osteomyelitis about 15 years ago at the 4th and 5th vertebral bo...

The patient is a 21-year-old female, diagnosed with cryptogenic cirrhosis at the age of 9. She presented with left post-pneumonic empyema that did not remit with conventional medical management and evolved with fistulization to the skin in the 7th intercostal space in the left subscapular region. We performed an open thoracic window procedure, and on the 6th day the patient was sent home with a...

Successful obliteration of an empyema cavity with vascularized flaps can, on occasion, best be accomplished using a free tissue transfer. A conjoint free muscle flap captures the immunological attributes of muscle necessary in the infectious milieu of these defects, augments the potential flap volume required to fill these often large defects, yet relies on only a single recipient site for the ...

Approximately 1 million patients develop parapneumonic effusions (PPEs) annually in the United States. The outcome of these effusions is related to the interval between the onset of clinical symptoms and presentation to the physician, comorbidities, and timely management. Early antibiotic treatment usually prevents the development of a PPE and its progression to a complicated PPE and empyema. P...

Introduction: The treatment of complicated parapneumonic effusion (PPE) and thoracic empyema (TE) is controversial; and the choice of treatment after confirming the failure of simple drainage remains unclear. The purpose of this study was to compare the outcomes of intrapleural urokinase (UK) administration and video-assisted thoracoscopic surgery (VATS) as initial treatment options for PPE and...

Today, in spite of the developments in imaging methods and antibiotherapy, childhood pleural empyema is a prominent cause of morbidity and mortality. In recent years, it has been shown that there has been an increase in the frequency of pleural empyema in children, and antibiotic resistance in microorganisms causing pleural empyema has made treatment difficult. Despite the many studies investig...

A 56-year-old man was admitted because of severe weight loss, anorexia, and dyspnea over a 2-month period. He had been diagnosed in 1985 with Crohn’s colitis and in 2001 he was admitted and underwent a total colectomy with formation of an ileostomy because of a severe disease flare. Subsequently, he had missed several follow-up outpatient consultations and was not taking any medication. On admi...

We read with great interest the article by Filomeno et al. They reported the follow-up of 44 patients with chronic pleural empyema treated with an ingenious prosthesis for open pleurostomy (POP), as an alternative to open thoracic window (OTW). However, some aspects need to be considered. First, the early closure of the stoma created at an OTW seems to be more related to individual technical pr...