BACKGROUND Significant morbidity and mortality result from the ineffective evacuation of empyema. Failure of conventional first line treatment with closed intercostal tube drainage and antibiotic therapy may result in fibrin deposition and loculated empyema. Enzymatic debridement using intrapleural instillation of streptokinase is a non-invasive therapeutic option which may obviate the need for...

BACKGROUND Empyema is an increasingly frequent clinical problem worldwide, and has substantial morbidity and mortality. Our objectives were to identify the clinical, surgical and microbiological features, and management outcomes, of empyema. METHODS A retrospective observational study over 12 years (1999-2010) was carried out at The Heart Hospital, London, United Kingdom. Patients with empyem...

BACKGROUND Defensins, also known as human neutrophil peptides, are antimicrobial peptides present in the azurophil granules of neutrophils. We measured their level in pleural effusion in various pulmonary diseases to investigate whether they could be used as a diagnostic marker in the differential diagnosis of specific pleural diseases. PATIENTS AND PARTICIPANTS We analyzed pleural effusion s...

BACKGROUND Pediatric empyema necessitates prompt resolution and early hospital discharge with minimal morbidity. However, the most effective treatment approach is not yet established. OBJECTIVES To assess the efficacy of an intrapleural streptokinase washing protocol as a non-operative treatment for stage II pediatric empyema as compared to operative decortications, by the number of pediatric...

The purpose of this paper is to present in summary three cases of subtotal pulmonary lobectomy and one case of total pneumonectomy, all of which were carried out in the presence of a complicating encapsulated empyema without preliminary drainage. It has been rather commonly considered in cases of pleural empyema complicating suppurative disease of the lung parenchyma that preliminary drainage s...

OBJECTIVE The present work aimed to retrospectively assess the outcomes associated with decortication by video-assisted thoracic surgery (VATS) in patients with tuberculous empyema. METHODS Patients (n = 274) who underwent decortication by VATS for surgical management of pleural empyema between January 2000 to 2010 were included. Pre-, intra-, and postoperative characteristics were observed f...

We report a clinical case of meningoencephalitis with subdural empyema in an immunocompromised farmer caused by toxigenic Clostridium perfringens type A, which was identified by 16S RNA gene analysis of cerebrospinal fluid and subdural empyema. In immunocompromised patients, C. perfringens should be considered a potential pathogen of sepsis.

Thoracic empyema and vertebral osteomyelitis is a rare combination. We report a case of vertebral osteomyelitis possibly caused by a progressive thoracic empyema. The causative pathogen was Escherichia coli. Computed tomographic (CT) scan and magnetic resonance imaging (MRI) suggested the diagnosis of vertebral osteomyelitis, confirmed by transthoracic needle aspiration and operative findings. ...

Seven patients with subdural empyema were initially treated by antibiotics without surgery. Six have recovered without sequelae. One required delayed surgery and has recovered with epilepsy. The authors emphasise the use of CT for the diagnosis and follow-up of subdural empyema, the principles and modalities of non-surgical treatment, and the good results, especially for late morbidity.