Background: Empyema thoracis may occur from parapneumonic pleural effusion and is associated with prolonged respiratory symptoms requiring longer times for drainage. Suppurative bacterial infections and tuberculosis are important causes; which if not treated early, may result to chronic empyema requiring thoracotomy and decortication. Objectives: To highlight the diagnostic and treatment challe...

Empyema toracis can be defined as a purulent pleural effusion. From 1998 to 2003 we treated 106 patients (87 men and 19 women), aged between 23 and 82 years, affected by localized empyema toracis. All of them received initially a chest tube and 73 of them (60 men and 13 women), in combination with selected antibiotics, had an uneventful recovery. Twenty three patients (17 men and 5 women) under...

INTRODUCTION In cases of empyema, some form of intervention, either chest tube drainage, thoracoscopy, video-assisted thoracic surgery (VATS), or thoracotomy, with or without pleural fibrinolysis, is required. What the best approach is and when and how to intervene is a matter of debate. STUDY OBJECTIVE To analyze the safety and outcome of medical thoracoscopy in the treatment of multiloculat...

Coelho et al. [1] investigated the use of C-reactive protein (CRP) levels for monitoring of patients with severe community-acquired pneumonia (CAP). They found that patients without a decrease in CRP levels on treatment had an increased mortality compared to patients with a rapid fall of this marker. The authors did not discuss another important use of the analysis of the time course of CRP lev...

BACKGROUND The empyema space is refractory to elimination of bacterial colonization. Electrolyzed saline (ES) was used as intra-pleural irrigation for rapid disinfection of the empyema space. PATIENTS AND METHODS Twenty consecutive patients with para-pneumonic empyema were reviewed in this study from 2007 to 2015. The empyema space was irrigated by miniaturized thoracoscopic surgery (mini VAT...

Empyema necessitatis is a rare complication of empyema in which the pleural infection spreads outside of the pleural space to involve the soft tissues of the chest wall. Most cases of empyema necessitatis are related to Mycobacterium tuberculosis and, less commonly, to Actinomyces spp. and Streptococcus spp. Staphylococcus aureus has rarely been reported as the causative agent of empyema necess...

INTRODUCTION The management of pediatric empyema remains controversial. We contend that early thoracoscopic intervention results in shorter hospital stays, decreased morbidity, and superior outcomes. We propose an algorithm using early image-guided thoracoscopy as an effective treatment for pediatric empyema. METHODS Consecutive pediatric empyemas treated from November 1997 to April 2001 usin...

OBJECTIVE To evaluate the results of thoracoscopy for the treatment of pleural empyema in pediatric patients. METHODS A retrospective study of 117 patients who underwent mediastinoscopy or video-assisted thoracoscopy for pleural empyema treatment. General anesthesia and single-lumen oral intubation were used. Surgery was indicated when there was pleural effusion and no clinical and radiologic...

AIM To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema. METHODS Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group I...

This study aimed to identify the bacterial etiology of empyema thoracis or parapneumonic pleural effusions in Thai children, with a focus on pneumococcus. This hospital-based, descriptive study included children aged < or = 16 years, diagnosed with empyema thoracis or parapneumonic pleural effusion, from whom a pleural fluid (PF) sample was taken between January 2008 and November 2009. PF and b...