"Empyema"

Empyema Skip to main contentSkip to searchEnglish (US)EnglishPortuguês中文Log in#{autosuggest.search}#{autosuggest.search}HomeEmpyemaVer contenido en español MENULog in or subscribe to access all of BMJ Best PracticeLast reviewed:13 Feb 2024Last updated:07 Mar 2024SummaryEmpyema is defined as the presence of pus in the pleural space.Risk factors include pneumonia, iatrogenic intervention in the pleural space, diabetes, and alcohol abuse.In patients with symptoms and signs of infection and a significant pleural effusion, thoracentesis (pleural aspiration) must be performed urgently.If empyema or a complicated parapneumonic effusion is diagnosed, a chest drain must be inserted urgently.A prolonged course of antibiotics is also required.If patients do not improve with antibiotics and drainage

Guidelines for the treatment of empyema (The Japanese Association for Chest Surgery) This article translates the guidelines for the treatment of empyema established by the Japanese Association of Chest Surgery in 2023 from Japanese to English. These guidelines were developed by the Working Group on Guidelines for the Treatment of Empyema of our society, involving the establishment of clinical receiving public comments from the members of the society. Even in the current era of advanced antibiotic therapy, empyema remains difficult to treat. However, the specific guideline for the treatment of empyema lacks in our country. Each institution is conducting clinical practices in its own way. Therefore, aiming to standardize the treatment of empyema, we have developed a practice guideline of empyema

Evaluation of a multiplex-qPCR for paediatric pleural empyema-An observational study in hospitalised children. Pleural empyema is a serious complication of pneumonia in children. Negative bacterial cultures commonly impede optimal antibiotic therapy. To improve bacterial identification, we developed a molecular assay and evaluated its performance compared with bacterial culture. Our multiplex -quantitative PCR to detect Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophilus influenzae was assessed using bacterial genomic DNA and laboratory-prepared samples (n = 267). To evaluate clinical performance, we conducted the Molecular Assessment of Thoracic Empyema (MATE) observational study, enrolling children hospitalised with empyema. Pleural fluids were tested

The outcomes of thoracoscopic decortication between fungal empyema and bacterial empyema. Fungal empyema is an uncommon disease and is associated with a high mortality rate. Surgical intervention is suggested in stage II and III empyema. However, there were no studies that reported the outcomes of surgery for fungal empyema. This study is a retrospective analysis in a single institute. Patients with empyema thoracis who underwent thoracoscopic decortication between January 2012 and December 2021 were included in the study. We separated the patients into a fungal empyema group and a bacterial empyema group according to culture results. We used 1:3 propensity score matching to reduce selection bias. There were 1197 empyema patients who received surgery. Of these, 575 patients showed positive culture

Comparison of Six versus Three Doses of Intrapleural Fibrinolytic Therapy in Children with Empyema: A Randomized Controlled Trial. To compare six doses of intrapleural streptokinase (SK) vs. the conventional three doses in children with empyema. In this randomized controlled trial, children with empyema received intrapleural streptokinase, either twice daily for 3 d (total 6 doses); or once to the conventional three doses in children with empyema, with comparable safety and cost.

Efficacy of medical thoracoscopy combined with fibrinolytic therapy in the treatment of complicated parapneumonic effusions and empyema. This study aimed to evaluate the clinical efficacy, safety, and feasibility of medical thoracoscopy combined with fibrinolytic therapy for the treatment of complicated parapneumonic effusions and empyema, with a focus on therapeutic outcomes and recovery offers significant advantages in the management of complicated parapneumonic effusions and empyema. This approach effectively enhances inflammation control, improves pulmonary function, and accelerates recovery time without compromising safety or increasing costs, underscoring its potential for broader clinical application.

The role of high dose corticosteroid (methylperednisolone pulse therapy) in treatment of multi-organ involvement after bacterial pneumonia and pleural empyema; "case series". Parapneumonic effusions and empyema usually occur after bacterial pneumonia. Inflammation plays an essential role in the occurrence of pneumonia and can lead to an autoinflammatory condition. In this study, we will present three cases including multi-organ involvement following pleural empyema that have been treated with pulse corticosteroid therapy. Apparently, pleural empyema can lead to multi-organ involvement due to underlying inflammatory processes. This condition is usually associated with symptoms and changes in laboratory parameters that manifest after empyema treatment or reappear after temporary recovery

A Retrospective Review of Concurrent versus Sequential Administration of Intrapleural Tissue Plasminogen Activator and Dornase alfa for Empyemas. Intrapleural tissue plasminogen activator (tPA) and dornase alfa (DNase) administered sequentially, separated by a one to two hour interval, is a mainstay of pleural infection treatment. Recent literature supports similar efficacy and safety

Six Versus Three Doses of Intrapleural Streptokinase in Childhood Empyema: A Randomized Controlled Trial. To compare the efficacy and safety of administering six doses of intrapleural streptokinase (SK) versus the conventional three doses, in children with empyema. In this open label, placebo-controlled, randomized trial, we enrolled 53 children with empyema, who received three doses for clinical improvement, duration of hospitalization, treatment failure, surgical decortication and adverse events. In children with empyema, intrapleural therapy with six doses of SK is not superior to three doses, although it is safe.

Relationship between oral health and prognosis in patients with empyema: Single center retrospective study with propensity score matching analysis. Empyema is a life-threatening infection often caused by oral microbiota. To the best of our knowledge, no reports have investigated the association between the objective assessment of oral health and prognosis in patients with empyema. A total of 63 patients with empyema who required hospitalization at a single institution were included in this retrospective study. We compared non-survivors and survivors to assess risk factors for death at three months, including the Renal, age, pus, infection, diet (RAPID) score, and Oral Health Assessment Tool (OHAT) score. Furthermore, to minimize the background bias of the OHAT high-score and low-score groups

Empyema Empyema - Symptoms, diagnosis and treatment | BMJ Best PracticeSkip to main contentSkip to search * About us * Help * Subscribe * Access through your institution * Log inBMJ Best Practice * Help * Getting started * FAQs * Contact us * Recent updates * Specialties * Calculators * Patient leaflets * Videos * Evidence * Drugs * Recent updates * Specialties * Calculators , diabetes, and alcohol abuse.In patients with symptoms and signs of infection and a significant pleural effusion, thoracentesis (pleural aspiration) must be performed urgently.If empyema or a complicated parapneumonic effusion is diagnosed, a chest drain must be inserted urgently.A prolonged course of antibiotics is also required.If patients do not improve with antibiotics and drainage of the pleural

The importance of the bacterial spectrum in the clinical diagnostics and management of patients with spontaneous pyogenic spondylodiscitis and isolated spinal epidural empyema: a 20-year cohort study at a single spine center. Personalized clinical management of spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) is challenging due to limited evidence of microbiologic findings

Subdural Empyema from Streptococcus suis Infection, South Korea. In Jeju Island, South Korea, a patient who consumed raw pig products had subdural empyema, which led to meningitis, sepsis, and status epilepticus. We identified Streptococcus suis from blood and the subdural empyema. This case illustrates the importance of considering dietary habits in similar clinical assessments to prevent

Pediatric intracranial empyema complicating otogenic and sinogenic infection. To describe and compare clinical and microbiological features, surgical and medical management, and outcomes of children with otogenic and sinogenic intracranial empyema (IE) in an institution with an established multidisciplinary protocol. To use the study findings to inform and update the institutional algorithm . Retrospective analysis was carried out on the electronic healthcare records of all children with oto-sinogenic IE admitted in a 5-year period. A total of 76 patients were identified and treated according to an institutional protocol. Two distinct groups were identified: intracranial empyema related to otogenic infection (OI-IE, n = 36) or sinogenic infection (SI-IE, n = 40). SI-IE was seen in older children

Empyema necessitans caused by methicillin-resistant Staphylococcus aureus: a case report and literature review. Empyema necessitans (EN) is a rare condition characterized by pleural infection with pus spreading into adjacent soft tissues. Although Mycobacterium tuberculosis and Actinomyces israelii are common causative agents, methicillin-resistant Staphylococcus aureus (MRSA) is relatively rare , but it is associated with high mortality in empyema cases. We aimed to report a unique case of EN caused by MRSA and present a literature review to better understand this rare condition. A 69-year-old man with a history of right ureteral stone presented with fever and left anterior thoracic pain. A physical examination revealed redness and swelling in the left thoracic region. Imaging studies confirmed EN with fluid

Double trouble: an unusual case of Klebsiella pneumoniae invasive syndrome with liver abscess, gallbladder empyema and infective endocarditis. Klebsiella pneumoniae invasive syndrome (KPIS) is characterized by primary pyogenic liver abscess associated with metastatic infections. Although rare, Klebsiella endocarditis carries a high mortality risk. A 60-year-old lady with type II diabetes mellitus presented with fever, malaise, right hypochondriac pain and vomiting for two weeks. Ultrasound abdomen revealed a collection within liver, and distended gallbladder with echogenic debris within. 3 days after ultrasound guided pigtail drainage of gallbladder empyema, newly presence murmur detected. Pus, urine, and blood cultures obtained were positive for Klebsiella pneumonia. Echocardiogram

A case report of empyema caused by Enterococcus gallinarum. Enterococcus gallinarum is an infrequently intestinal symbiotic pathogen associated with nosocomial infection in immunocompromised individuals. To date, rare cases of pulmonary infection attributable to Enterococcus gallinarum were reported. Herein, we presented the first case of empyema resulting from Enterococcus gallinarum infection of urokinase along with thoracic drainage. Following surgery, He took oral linezolid for over one month. Undergoing comprehensive treatment, the patient exhibited favorable recovery. We reported the first case of empyema due to Enterococcus gallinarum infection. It should be suspected in patients with impaired immune function and invasive therapies, without responding to conventional anti-infectious

Pneumonia With Empyema: A Rare Clinical Presentation of Bartonella henselae Infection in a 10-Year-Old Boy. Cat-scratch disease is a common zoonosis in children. However, atypical clinical presentation of cat-scratch disease is less common, and lung involvement is particularly rare. The usual presentation of lung disease in bartonellosis includes other organ involvement and is more common in immunocompromised patients. We present a 10-year-old immunocompetent patient with pneumonia and inoculated empyema caused by Bartonella henselae, without any other organ involvement, which occurred 2 weeks after lymphadenopathy. The definite diagnosis was established using the polymerase chain reaction of the empyema obtained from thoracocentesis. The boy was treated with several antibiotics (ceftriaxone

Management of patient with Fusobacterim nucletum related pleural empyema: intrapleural antibiotic therapy can be considered for salvage therapy. Pleural empyema can lead to significant morbidity and mortality despite chest drainage and antibiotic treatment, necessitating novel and minimally invasive interventions. Fusobacterium nucleatum is an obligate anaerobe found in the human oral and gut microbiota. Advances in sequencing and puncture techniques have made it common to detect anaerobic bacteria in empyema cases. In this report, we describe the case of a 65-year-old man with hypertension who presented with a left-sided encapsulated pleural effusion. Initial fluid analysis using metagenomic next-generation sequencing (mNGS) revealed the presence of Fusobacterium nucleatum and Aspergillus

INTRAPLEURAL FIBRINOLYSIS WITH UROKINASE VERSUS ALTEPLASE IN COMPLICATED PLEURAL EFFUSIONS AND EMPYEMA: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL. Intrapleural fibrinolytic therapy is being used as an effective agent since 1949 in managing complicated pleural effusion and empyema. Several agents like streptokinase (STK), urokinase (UK), and recombinant tissue plasminogen activator (rt-PA (within 6 weeks of onset of symptoms) have shown greater response than who reported late for intervention. IPFT is a safe and effective option in managing complicated pleural effusion or empyema, and newer agents like alteplase have greater efficacy and similar adverse effects effect profile when compared with conventional agents like UK.