201
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Jezierska-Anczuków A, Rudziński P, Wróblewska M, Kozińska A. [Etiologic factors of pleural empyema as a potential source of nosocomial infections]. Pneumonol Alergol Pol 2003; 71:59-67. [PMID: 12959025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Pleural empyema still comprises an important therapeutic problem despite the availability of effective antibiotic therapy. This disorder is characterised by 20% mortality rate. Moreover, the involvement of multi-drug resistant bacterial strains may pose a risk of a nosocomial spread to other hospitalised patients. In the present study we have analysed 184 bacterial strains isolated from 63 patients with pleural empyema. A predominance of aerobic bacteria was detected, both Gram-positive cocci and Gram-negative bacilli. Staphylococci isolated from the clinical samples were characterised by a high percentage of strains resistant to gentamicin (86.3%) and methicillin (38.2%). The other important etiological agents were Pseudomonas aeruginosa and Gram-negative enteric rods of the Enterobacteriaceae family. Only 1 strain of anaerobic bacteria was detected. The enteric bacilli were characterised by a low percentage of isolates susceptible to most of the tested antibiotics (< 60%), with an exception of ciprofloxacin (68%) and imipenem (100%). These multi-drug resistant strains may spread nosocomially to other patients.
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202
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Rzyman W, Jassem E, Dziadziuszko R, Kurowski K, Sternau A, Skokowski J. [Results of treatment for chronic pleural empyema]. Pneumonol Alergol Pol 2003; 71:43-50. [PMID: 12959023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
UNLABELLED The aim of the study was to assess the results of the treatment in 97 patients with chronic pleural empyema treated in the department of thoracic surgery between 1988 and 1997. The majority of patients were between 30 and 50 years old. Most of the group were men and more than a half had a concomitant disease, which may predispose to empyema development. Nevertheless all the empyemas were in the chronic phase 1/3 of patients were successfully treated only with closed chest tube drainage and the remaining group with lung decortication. The Gram-negative bacterial flora dominated in the culture from empyema sac. Spirometric values and blood gas analysis showed significant reduction of lung function before the treatment. We found the relation between an early institution of closed tube drainage and the shorter stay at the hospital. Moreover in a significant proportion of patients pleural drainage was a sufficient way of treatment. CONCLUSIONS Drainage of the empyema should be performed at early phase of the disease. It should be recommended that pleural drainage precede the surgical management of empyema. Delate of surgical intervention is the main cause of the high mortality rate in empyema following esophageal perforation.
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203
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Abstract
AIMS To study the clinical and microbial profile of childhood empyema in South Asia and to identify the changes over the past three decades. METHODS A total of 265 children (aged 1 month to 12 years) with empyema admitted to the Advanced Pediatric Center, PGIMER, Chandigarh, India in 1989-98, were reviewed retrospectively. RESULTS AND CONCLUSIONS One third of children were under 5. Culture positivity had decreased significantly (48% v 75%) over the years. Staphylococcus aureus continues to be the commonest (77%) aetiological agent; clustering was seen during hot and humid months (46%). Culture positive Streptococcus pneumoniae cases also decreased (9% v 27%); all were seen during the winter and spring season. Gram negative rods grew in more patients (11% v 7%). Community acquired methicillin resistant S aureus (MRSA) was isolated in three patients. Most children (93%) were treated with parenteral cloxacillin and an aminoglycoside. Tube drainage (TD) was used in 92% of fibropurulent cases, and was successful in 79%. Of 48 patients with failed TD, 12 needed decortication; limited thoracotomy was sufficient in the remaining 36. Surgery was mainly required by children with persistent pleural sepsis after 10 days of TD. Delaying surgery until 14 days had a significantly higher potential of requiring decortication. Early change to oral antibiotics (after 1-2 weeks of parenteral therapy) reduced the hospital stay significantly (17+7 v 23+7 days) without compromising long term outcome. Twenty two patients presenting late in the chronic stage underwent decortication at admission.
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Affiliation(s)
- A K Baranwal
- Department of Pediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
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204
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Caksen H, Oztürk MK, Yüksel S, Uzüm K, Ustünbaş HB. Childhood parapneumonic pleural effusion and empyema. J Med 2003; 33:265-8. [PMID: 12939123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- Hüseyin Caksen
- Yüzüncü Yýl University Faculty of Medicine, Department of Pediatrics, Van, Turkey
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205
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Abstract
Parapneumonic effusion and empyema thoracis remains a significant source of morbidity in children, though the overall incidence of empyema thoracis has decreased in the past two decades. These conditions pose a dilemma regarding evaluation and treatment for the treating physician. This article discusses the practical strategies in the management of empyema thoracis in children.
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206
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Abstract
AIMS To gather data on the clinical presentation of parapneumonic effusion and empyema and to examine the effect of different management strategies on short term outcomes. METHODS Retrospective case note review of 48 children admitted to a tertiary unit between January 1998 and March 2001. Effusions were classified into three stages dependent on ultrasound findings. RESULTS The stage of effusion was not associated with duration of previous symptoms or length of previous admission. An interventional procedure was performed on median day 2 of admission in 46 children: eight (17%) had an intercostal drain alone, 14 (29%) had an intercostal drain followed by intrapleural fibrinolytic therapy, and 24 (50%) had a thoracotomy. Three children who had an initial intercostal drain alone returned to theatre for thoracotomy, and two children who had intrapleural fibrinolysis returned for thoracotomy. Median length of stay (interquartile range) for each initial procedure was 15 days (6-20) for intercostal drain alone, 8 days (6-12) for fibrinolytic therapy, and 6.5 days (5-9) for thoracotomy. Stay for intercostal drain alone was significantly longer than for thoracotomy. CONCLUSION Early surgical management of empyema is associated with a favourable outcome.
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207
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208
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Abramzon OM, Kirillov DA, Pan'kov AS, Perunova NB, Elagina NN, Valyshev AV, Bukharin OV. [Modifying action of oxytocin on the biological properties of the causative agents of anaerobic non-clostridial infection]. Zh Mikrobiol Epidemiol Immunobiol 2003:71-4. [PMID: 12966884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
In a number of in vitro experiments the effect of oxytocin on the antilysozyme and anticomplemental activity of Propiobacterium propionicum, Bacteroides fragilis, Prevotella melaninogenica and Peptostreprtococcus anaerobius, isolated from patients with acute pyoinflammatory pleuropulmonary diseases, was studied. Antibiotic resistance dynamics of the infective agents under study to lincomycin, clindamycin, thienam, vancomycin was also detected. The inhibiting activity of oxytocin on the persistence properties of B. fragilis, P. melanogenica and P. anaerobius was noted. Under the influence of the preparations used changes in the sensitivity of the strains to a number of antibiotics of the lincosamide, carbapenem and glycopeptide groups were found to occur. The data thus obtained were indicative of the possible mechanisms of action of oxytocin in the treatment of acute pyoinflammatory pleuropulmonary diseases of anaerobic nonclostridial etiology.
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Affiliation(s)
- O M Abramzon
- Institute of Cellular and Intracellular Symbiosis, Orenburg, Russia
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209
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Abramzon OM, Elagina NN, Kartashova OL, Valyshev AV, Kirgizova SB, Valysheva IV, Perunova NB. [Microflora isolated in acute inflammatory pulmonary and pleural diseases]. Zh Mikrobiol Epidemiol Immunobiol 2003:44-7. [PMID: 12966876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The species composition and biological properties of microflora isolated from 42 patients with acute inflammatory pulmonary and pleural diseases were studied. A wide spectrum of aerobic and anaerobic microorganisms was detected. Infective agents causing severe course of the infectious process were found to have a high level of persistence properties.
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Affiliation(s)
- O M Abramzon
- Institute of Cellular and Intracellular Symbiosis, Clinical Hospital, Orenburg, Russia
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210
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Abstract
A cluster of 5 family members, a mother and 4 children, were hospitalized for severe group A Streptococcus (GAS) pneumonia. Three family members had complications: sepsis (1), empyema (2), and a sterile parapneumonic effusion (1). Two additional family members had symptoms of upper respiratory tract infection, and 1 was hospitalized for these symptoms. GAS was isolated from the blood of 1 patient, the pleural fluid of 2 patients, and the oropharynx of 6 patients. Pulsed field gel electrophoresis testing revealed an identical deoxyribonucleic acid pattern in all 7 isolates. Genotyping revealed the speA gene and serotyping the T-1, M-1 serotype in all isolates. This family cluster of invasive GAS disease is the largest reported to date, with an attack rate of 41.7% (5 of 12 family members). This report provides further support for antibiotic prophylaxis of close contacts of individuals with invasive GAS disease.
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MESH Headings
- Anti-Bacterial Agents
- Child
- Contact Tracing
- DNA, Bacterial/analysis
- Disease Outbreaks
- Disease Transmission, Infectious/prevention & control
- Drug Therapy, Combination/therapeutic use
- Electrophoresis, Gel, Pulsed-Field
- Empyema, Pleural/drug therapy
- Empyema, Pleural/microbiology
- Empyema, Pleural/surgery
- Family Health
- Female
- Genotype
- Humans
- Male
- Middle Aged
- Pharyngitis/microbiology
- Pneumonia, Bacterial/microbiology
- Serotyping
- Shock, Septic/microbiology
- Streptococcal Infections/drug therapy
- Streptococcal Infections/microbiology
- Streptococcal Infections/prevention & control
- Streptococcal Infections/surgery
- Streptococcal Infections/transmission
- Streptococcus pyogenes/classification
- Streptococcus pyogenes/genetics
- Streptococcus pyogenes/isolation & purification
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Affiliation(s)
- Sumita Roy
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA
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211
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Oskorouchi AR, Licheri S, Pisano G, Erdas E, Casu B, Crobu F, Pomata M. [Left pyo-pneumothorax: a rare complication of colon carcinoma]. Tumori 2003; 89:135-7. [PMID: 12903572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
A case of pio-pneumothorax complicating a splenic flexure colonic carcinoma is herein presented. The patient was a 58 years old male and was submitted 3 months earlier to a colo-colic bypass for a locally advanced tumor infiltrating stomach, spleen, tail of the pancreas and left emidiaphragm. Few days before the admittance in our ward, he experienced fever, anorexia, and severe dispnoea. Treatment was a water seal drainage of the chest evacuating nearly 8 Liters of purulent material where Escherichia coli was found. Death occurred 2 weeks after drainage. From the analysis of the literature thoracic empyema is an extremely rare complication of colonic carcinoma: 5 other cases have been reported so far. Pathogenesis in half of the cases was due to septicemia and in the others to infectious local spreading.
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Affiliation(s)
- A R Oskorouchi
- Dipartimento di Scienze Chirurgiche e Trapianti d'Organo, Sezione di Chirurgia Generale II, Università degli Studi, Cagliari
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212
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Rovera F, Imperatori A, Militello P, Morri A, Antonini C, Dionigi G, Dominioni L. Infections in 346 consecutive video-assisted thoracoscopic procedures. Surg Infect (Larchmt) 2003; 4:45-51. [PMID: 12744766 DOI: 10.1089/109629603764655272] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Postoperative infections, as related to risk factors, in patients undergoing video-assisted thoracoscopic surgery (VATS) procedures have been studied infrequently. MATERIALS AND METHODS We evaluated 346 consecutive patients who underwent VATS procedures between October 1996 and June 2002 at our center. Patients preoperatively were free of chest infections and were divided into two groups: Group A (n = 139) who underwent lung wedge resection; group B (n = 207), who underwent pleural biopsy (n = 183) or biopsy of a mediastinal mass (n = 24). We recorded prospectively the following preoperative infection risk parameters: Hemoglobin concentration, hematocrit, serum albumin concentration, lymphocyte count, length of preoperative stay, duration of surgery, blood transfusion, age, comorbidity, and chronic obstructive pulmonary disease specifically (COPD, measured as FEV(1) <70% of expected). Short-term antibiotic prophylaxis was given to 94% of patients in group A and to 90% of patients in group B. As outcome measures we recorded the occurrence of postoperative infections within 30 days (surgical site infection, pneumonia, empyema) and the final patient outcome. RESULTS Patients who developed postoperative infections (all the above types included) were 17/346 (4.9%), the difference between group A (5.0%) and group B (4.8%) being not significant. The overall surgical site infection rate was 1.7%. Groups A and B showed a similar incidence of surgical site infection (2.8% vs. 1.0%; p = NS), of pneumonia (2.8% vs. 3.4%; p = NS), and of empyema (0.7% vs. 2.0%; p = NS). Among assessed infection risk parameters, a FEV(1) <70% of expected was the only parameter associated with a significantly increased incidence of surgical site infection (p < 0.05). CONCLUSIONS This prospective study confirms that the wound infection rate is low (1.7%) after minimally invasive VATS procedures. The cumulative incidence of postoperative infections (including wound infection, pneumonia, empyema) was similar after lung wedge resection and after pleural or mediastinal mass biopsy procedures. Among the infection risk parameters, COPD was the only parameter associated with a significantly increased incidence of postoperative infection. Our results suggest that patients with COPD who undergo VATS for lung wedge resections and for pleural/mediastinal biopsy should receive antibiotic prophylaxis to prevent surgical site infection.
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Affiliation(s)
- Francesca Rovera
- Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo di Varese, Varese, Italy
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213
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Abstract
Invasive Pasteurella multocida infection, although uncommon, has been recognized to occur more frequently among patients with hepatic cirrhosis. This study reports a fatal case of bacteremic P. multocida empyema without pneumonia associated with refractory septic shock in a patient with both cirrhosis and asplenia.
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Affiliation(s)
- Kevin B Laupland
- Department of Critical Care Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
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214
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Abstract
Yersinia enterocolitica is a well-known cause of enterocolitis. Although focal extraintestinal manifestations and disseminated disease have been described, usually in immunosuppressed patients, infection in the chest seems to be rare. We report the case of an alcoholic man who had spontaneous pleural empyema due to Y. enterocolitica.
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Affiliation(s)
- Ali Mofredj
- Service de réanimation, Hôpital Laennec, Creil, France.
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215
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216
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Abramzon OM, Kartashova OL, Valyshev AV, Kirillov DA, Perunova NB, Elagina NN, Valysheva IV, Bukharin OV. [Experimental and clinical study of the effect of antibiotics, oxytocin and their combinations on resistance of pathogens causing acute suppurative-inflammatory diseases of lungs and pleura]. Antibiot Khimioter 2003; 48:14-7. [PMID: 15176098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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217
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Sánchez Serrano FJ, Zubiaur Cantalapiedra A, Roig Rico P, Montagud Moncho JB. [Two cases of empyema caused by Peptostreptococcus]. Rev Med Chil 2002; 130:1435-7. [PMID: 12611246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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218
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Romero Requena JM, Márquez Pérez FL, Gómez Vizacaino MT, Pimentel J, Gómez de Tejada R, Fuentes Otero F, Bureo Dacal P, Perez Miranda M. [Acute alopecia associated to empyema caused by actinomyces]. An Med Interna 2002; 19:658-9. [PMID: 12593045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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219
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Córdoba-López A, Bueno Alvarez-Arenas MI, Monterrubio-Villa J, Corcho-Sánchez G. [Streptococcus agalactiae pleural empyema in a healthy adult]. Enferm Infecc Microbiol Clin 2002; 20:478-9. [PMID: 12425886 DOI: 10.1016/s0213-005x(02)72848-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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220
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Aoki F, Sando Y, Okamoto S, Koizumi S, Maeno T, Nakagawa J, Suga T, Kurabayashi M. Bilateral empyema mimicking cardiac tamponade. Respiration 2002; 69:350. [PMID: 12169750 DOI: 10.1159/000063259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Fumiaki Aoki
- Department of Medicine, Social Insurance Gunma Chuo General Hospital, Maebashi, Gunma, Japan
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221
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Behnia M, Clay AS, Hart CM. Enterococcus faecalis causing empyema in a patient with liver disease. South Med J 2002; 95:1201-3. [PMID: 12425509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A 57-year-old man with a history of liver disease had shortness of breath, fever, and pleuritic chest pain. Ascites was not present. Computed tomography (CT) of the chest revealed a large unilateral pleural effusion, compressive atelectasis, and no evidence of consolidation. Culture of the pleural fluid grew Enterococcus faecalis. Treatment with ampicillin in conjunction with tube thoracostomy resulted in clinical improvement. This case illustrates the development of spontaneous monomicrobial empyema due to E. faecalis in a patient with liver disease, in the absence of pneumonia and peritonitis.
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Affiliation(s)
- Mehrdad Behnia
- Department of Medicine, Richard L. Roudebush Veterans Affairs Medical Center, and Indiana University Medical Center, Indianapolis, USA
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222
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Abstract
Empyema is a rare but recognized complication of bacterial pneumonia in children. The incidence of empyema may be rising as vaccination practices and antibiotic prescribing practices promote the emergence of more virulent and resistant organisms. Diagnostic methods vary widely, from thoracentesis to plain radiographs to detailed computed tomography scans. Treatment practices also vary, with some practitioners preferring medical treatment, others employing chest tube drainage or fibrinolytic therapy, and still others aggressively pursuing surgical options. Further study is needed to define the ideal management of empyema. The authors review the current literature and propose an updated management algorithm that incorporates accepted practices as well as emerging trends in diagnosis and management of empyema.
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Affiliation(s)
- Rachel A Lewis
- Department of Pediatrics, Children's Hospital of New York-Presbyterian, New York, NY 10032, USA.
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223
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Abstract
OBJECTIVE To identify risk factors associated with development of pyothorax in cats, assess survival rates for cats that are treated, determine prognostic indicators, and determine recurrence rates. DESIGN Retrospective study. ANIMALS 80 cats with pyothorax and 212 control cats. PROCEDURE History; month of evaluation; physical examination findings; results of hematologic, serum biochemical, and retrovirus testing; radiographic findings; outcome; recurrence rate; and necropsy findings were recorded. For control cats, age, sex, breed, indoor versus outdoor status, vaccination history, and single- versus multi-cat household status were recorded. RESULTS Cats from multi-cat households were 3.8 times as likely (95% confidence interval, 1.9 to 8.2) to develop pyothorax, compared with cats from single-cat households. Indoor or outdoor status was not a risk factor. Cats with pyothorax were significantly younger (mean, 3.83 +/- 3.43 years) than controls (mean, 5.62 +/- 5.27 years). Nonsurvivors had significantly lower heart rates than survivors. Hypersalivation was significantly more common in nonsurvivors (11/39; 26.8%) than survivors (1/39; 3%). Overall, 48.8% (39/80) of cats survived. When cats that were euthanatized without treatment were excluded from analyses, the survival rate was 66.1% (39/59). Pyothorax recurred in 1 of 17 cats for which follow-up information was obtained. CONCLUSIONS AND CLINICAL RELEVANCE Cats with pyothorax that received treatment had a fair to good prognosis, with low recurrence rates in survivors. Hypersalivation and low heart rate were associated with worse clinical outcome. Cats with pyothorax were likely to come from multi-cat households.
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Affiliation(s)
- Lori S Waddell
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia 19104-6010, USA
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224
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Lau SKP, Woo PCY, Chan BYL, Fung AMY, Que TL, Yuen KY. Haemophilus segnis polymicrobial and monomicrobial bacteraemia identified by 16S ribosomal RNA gene sequencing. J Med Microbiol 2002; 51:635-640. [PMID: 12171293 DOI: 10.1099/0022-1317-51-8-635] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This paper reports a case of Haemophilus segnis polymicrobial bacteraemia and a case of H. segnis monomicrobial bacteraemia identified by 16S ribosomal RNA gene sequencing. In the first case, a gram-negative aerobic coccobacillus was isolated with Streptococcus intermedius and S. sanguis from the blood culture of a 32-year-old intravenous drug addict with left thoracic empyema. In the second case, a gram-negative aerobic coccobacillus was isolated from the blood culture of an 82-year-old woman with Clostridium difficile colitis and septicaemic shock. Both gram-negative coccobacilli grew on chocolate agar as colonies of 1 mm in diameter after incubation for 24 h at 37 degress C in air with CO2 5%, but only to pinpoint sizes on blood agar under the same incubation conditions. Both strains were factor V-dependent, but not factor X-dependent. For the first isolate, the Vitek system (NHI) showed that it was 56% likely to be Actinobacillus actinomycetemcomitans and 40% Neisseria subflava; whereas the API system (NH) showed that it was 58% likely to be H. aphrophilus/paraphrophilus and 42% H. parainfluenzae. For the second isolate, the Vitek system (NHI) showed that it was 95% likely to be H. influenzae VIII; whereas the API system (NH) showed that it was 58% likely to be H. aphrophilus/paraphrophilus and 42% H. parainfluenzae. 16S rRNA gene sequencing showed that there were four base differences between isolate 1 and H. segnis and two base differences between isolate 2 and H. segnis, indicating that both isolates most closely resembled a strain of H. segnis. Only two cases of H. segnis bacteraemia were found in the English scientific literature, one in a case of infective endocarditis and the other in a case of pancreatic abscess. Including the present two cases, the overall mortality of H. segnis bacteraemia was 50%.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Bacteremia/microbiology
- Colitis/microbiology
- Colitis/pathology
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- Empyema, Pleural/microbiology
- Female
- Haemophilus/classification
- Haemophilus/genetics
- Haemophilus/growth & development
- Haemophilus Infections/microbiology
- Humans
- Male
- Phylogeny
- Polymerase Chain Reaction
- RNA, Ribosomal, 16S/chemistry
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA
- Sequence Homology, Nucleic Acid
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Affiliation(s)
- Susanna Kar-Pui Lau
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
| | - Patrick Chiu-Yat Woo
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
| | - Benedict Yin-Leung Chan
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
| | - Ami Mei-Yuk Fung
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
| | - Tak-Lun Que
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
| | - Kwok-Yung Yuen
- Department of Microbiology, University of Hong Kong, Queen Mary Hospital, and Department of Microbiology, Tuen Mun Hospital, Hong Kong
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225
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Celandroni A, Cinquanta L, Caprai S. [Jacopo's chest (bad history of a pleural empyema). A case report]. Pediatr Med Chir 2002; 24:308-12. [PMID: 12197092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
We present a case of pleural empyema, occurred in a healty 7 years boy. He was admitted to our hospital because of a lobare pneumonitis. The patient was administered with a 2 degrees generation Cefalosporine given intramuscularly and with Corticosteroid (1 mg/kg/die). After an initial improvement of his clinical conditions, he got worse so that he underwent a TC scan which showed the presence of a left pleural empyema requiring the insertion of an intercostal tube drainage followed by an intervention of decortication. The boy had some evidence of a staphylococcal etiology such as the evolution in empyema itself, the augmentation of antistafilolisinic title found during the illness, and the typical finding of blebs on chest radiograph. As cultures from both blood and drainage liquid samples remained sterile, we were unable to demonstrate a clear bacterial etiology of the empyema. It remains doubtful if corticosteroid administration could contribute to the severity of the pneumonia evolution.
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Affiliation(s)
- A Celandroni
- Università degli Studi di Pisa, Divisione e UO di Pediatria II, Dipartimento di Medicina della Procreazione e dell'Età Evolutiva, Via Roma 67, 56126 Pisa.
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226
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Abstract
Three radio-collared striped skunks (Mephitis mephitis) found dead during a field study of winter ecology of striped skunks near Willowbrook, Saskatchewan, Canada were examined. Streptococcus equisimilis was identified as the primary agent causing necrotizing purulent pneumonia in one skunk and suppurative meningoencephalitis in another. Both Streptococcus equisimilis and Streptococcus canis were isolated from lesions of purulent myocarditis and pyothorax in the third skunk. These are apparently the first reported cases of S. equisimilis infection in striped skunks and suggest that this opportunistic pathogen may be a significant cause of mortality under some conditions.
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Affiliation(s)
- Yeen Ten Hwang
- Department of Biology, University of Saskatchewan, 112 Science Place, Saskatoon, Saskatchewan, S7N 5E2, Canada.
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227
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Huang FL, Chen PY, Ma JS, Yu HW, Lu KC, Chi CS, Lau YJ, Peng HC. Clinical experience of managing empyema thoracic in children. J Microbiol Immunol Infect 2002; 35:115-20. [PMID: 12099332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Data of 54 children with a diagnosis of thoracic empyema at a medical center in central Taiwan from January 1991 through April 2001 were analyzed. Their mean age was 4.4 years and the mean hospital stay was 13 days. Streptococcus pneumoniae was the most common pathogen, followed by Staphylococcus aureus and Haemophilus influenzae. These patients were divided into 2 groups according to the treatment method. Twenty-two patients were treated successfully with antibiotics and tube thoracostomy, whereas the other 32 children required further pleural decortication with antibiotic treatment. In patients with empyema, decortication allowed for more rapid defervescence than did closed tube thoracostomy (1.94 vs 5.04 days; p<0.001) and there were no complications in the group that underwent decortication treatment (p<0.03). In conclusion, the decortication of loculated empyema thoracis in children is a safe and effective management procedure.
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Affiliation(s)
- Fang-Liang Huang
- Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, ROC
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228
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Chafik A, Kabiri H, Smahi M, Achir A, el Masslout A, Benosman A. [Pyothorax in pneumonectomy cavity. Apropos of 24 cases]. Rev Pneumol Clin 2002; 58:145-150. [PMID: 12486798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
AIM OF THE STUDY Describe as series of post-pneumonectomy empyema episodes, with or without bronchial fistula treated at the department of Thoracic Surgery, University of Ibn Sina, Rabat, Morocco. PATIENTS, METHOD AND RESULTS Twenty-four patients with post-pneumonectomy pyothorax cared for between 1991 and 2000 were reviewed retrospectively. There were 15 men and 9 women, mean age 34 years. Pneumonectomy was indicated for tuberculous pyothorax and destroyed lung (n = 8), 8 destroyed lung (n = 8), pulmonary aspergilloma (n = 2), pulmonary hydatidosis (n = 2), bronchial dilatation (n = 2), lung cancer (n = 1), and bullet wound (n = 1). The patients were divided into two groups according to presence or absence of bronchial fistula: group 1, 19 patients with without bronchial fistula, and group 2 5 with bronchial fistula. Fourteen patients in group 1 (73.7%) achieved definitive cure, 12 after drainage and washout (63%) at mean delay of 45 days and 2 after drainage and washout with thoracoplasty. Five patients did not respond to hospital drainage and washout and remained under definitive ambulatory drainage as they declined further surgical treatment. One death occurred in this group. Two patients in group 2 (40%) achieved definitive cure, one after daily aspiration, and the other after thoracoplasty. Two fistulae in one patient were treated with nitratage. For this patient, we also attempted revision of the bronchial stube via posterior throacotomy, the closure of the bronchial fistula using an intercostal muscle flap associated with thoracoplasty. All these methods failed. There were two deaths in this group. CONCLUSION Sixteen patients were definitively cured (66.6%). Eight patients (33.3%) remain in a chronic condition. Patients with pyothorax on a pneumonectomy cavity should be managed in specialized centers before reaching the chronic stage. Thoracomyoplasty with preparation of the cavity by thoracostomy should be proposed.
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Affiliation(s)
- A Chafik
- Service de Chirurgie Thoracique, CHU Ibn Sina, Rabat, Maroc.
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229
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Nishiuchi S, Nonomura T. [Mycotic descending thoracic aortic aneurysm complicated by pyothorax postoperatively: report of a case]. Kyobu Geka 2002; 55:502-4. [PMID: 12058464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We experienced with a case of mycotic descending thoracic aortic aneurysm (MTAA) complicated by pyothorax postoperatively. The graft replacement accompanied with wrapping by omental pedicle flap (OPF) was performed in this case. We considered that causative organism for MTAA was Salmonella species, and discussed effectiveness of the application of OPF to MTAA.
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Affiliation(s)
- S Nishiuchi
- Department of Thoracic and Cardiovascular Surgery, Kobe City General Hospital, Kobe, Japan
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230
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Chien JY, Shih JT, Hsueh PR, Yang PC, Luh KT. Vibrio alginolyticus as the cause of pleural empyema and bacteremia in an immunocompromised patient. Eur J Clin Microbiol Infect Dis 2002; 21:401-3. [PMID: 12072928 DOI: 10.1007/s10096-002-0726-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J Y Chien
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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231
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Yilmaz E, Doğan Y, Aydinoğlu AH, Gürgöze MK, Aygün D. Parapneumonic empyema in children: conservative approach. Turk J Pediatr 2002; 44:134-8. [PMID: 12026201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Forty-nine patients, aged 3 months to 13 years, were studied to determine the clinical presentation, bacteriology, treatment and outcome of empyema complicating pneumonia in children. There were 28 (57.2%) males and 21 (42.8%) females in the study, with a male/female ratio of 1.3/1. We found malnutrition in 15 (30.6%) patients. The most common symptoms at presentation were fever (93.8%) and cough (85.7%). Radiography demonstrated minimal effusions (6 patients, 12.2%), moderate effusions (23 patients, 46.9%), and massive effusions (20 patients, 40.9%). The pleural fluid was on the right side in 26 (53.1%) cases, the left side in 17 (34.6%) cases, and bilateral in 6 (12.3%) cases. Staphylococcus aureus was the most frequently isolated microorganism in pleural fluid. No organism was recovered in 33 (67.3%) patients. Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Decortication was carried out in only two patients. The hospitalization period was 28.02 +/- 10.18 days (11 to 57 days). There was one death due to widespread Staphylococcus aureus septicemia. All patients who were followed-up showed complete or near complete resolution of the chest radiography at six months, regardless of severity of disease or treatment modality. Children with pleural empyema can be successfully treated with appropriate antimicrobial therapy and adequate closed chest tube drainage. Further surgical intervention is rarely required.
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Affiliation(s)
- Erdal Yilmaz
- Department of Pediatrics, Firat University Faculty of Medicine, Elaziğ, Turkey
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232
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Abstract
OBJECTIVE The aim of this retrospective study was to review pleural and pericardial complications of patients with hydatid cysts and to analyze the management of therapy for these patients. METHODS Between 1991 and 2001, 43 (29.7%) of 145 patients presented with pleural and pericardial complications. These patients had spontaneous pneumothorax (6.2%), empyema (7.6%), pleural thickening (10.3%), hepatopleural fistula (2.8%), pericarditis (2.1%), and hepatobronchial fistula (0.7%). There were 22 male and 21 female patients, with a mean age of 30 years. RESULTS The most common symptom was chest pain (79.1%). In 37 (86.1%) of 43 patients, the cysts were unilateral. The ratio of ruptured cysts was 88.4%. In most of the patients, hydatid cysts developed in the right lung (62.9%) and the lower lobes of the lung (70.4%). Multiple cysts were found in 8 (18.6%) patients. The most common surgical techniques were cystotomy with capitonnage (55.7%) and decortication (69.8%). Radical lung resection was used in 14% of the patients. The morbidity rate was 16.3%, and the mortality rate was 2.3%. The mean follow-up was 19 months with no recurrence. CONCLUSIONS Although lung-preserving surgical interventions should be preferred, radical surgical procedures have been used more commonly in patients with pleural complications of hydatid cysts, and the postoperative morbidity rate was higher in these patients. Because of this, the surgical treatment should be carried out before the development of pleural complications. In addition, echinococcosis should be considered and included in the differential diagnosis of spontaneous pneumothorax and empyema.
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Affiliation(s)
- Olgun Kadir Aribas
- Department of Thoracic Surgery, Medical School of Selcuk University, 42080 Meram-Konya, Turkey.
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233
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Abstract
Non-tuberculous mycobacteria (NTM) have emerged as important pathogens in organ transplant recipients. Because NTM pulmonary infections vary in their clinical and radiographic presentations, heightened clinical suspicion is necessary for accurate diagnosis. We report a case of Mycobacterium abscessus empyema in a lung transplant recipient. Repeated attempts at identifying the organism from a variety of clinical specimens led to the correct diagnosis and treatment.
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Affiliation(s)
- Rick M Fairhurst
- Division of Infectious Diseases, Department of Medicine, UCLA Medical Center, Los Angeles, California 90095, USA
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234
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Permin H, Høiby N. [Diagnosis of infectious disease. Actinomycosis]. Ugeskr Laeger 2002; 164:1195-6. [PMID: 11899504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Henrik Permin
- Epidemiklinikken M5132, H:S Rigshospitalet, DK-2100 København. rh01813rh.dk
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235
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Petrov D, Dzhambazov V, Minchev T, Plochev M, Goranov E, Krupev M, Petkov R. [Omentoplasty in surgical management of postpulmonectomy pleural empyema]. Khirurgiia (Mosk) 2002; 55:13-5. [PMID: 11484240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
A method of treating postpulmonectomy pleural empyema, practically implemented in this country for the first time, is described. Three patients are subjected to operation. Right pulmonectomy for lung cancer and chronic inflammatory process is done twice, and left pleuropulmonectomy for tuberculosis--once. Postpulmonectomy empyema persists in all three cases regardless of the adequate continuous suction drainage and intrapleural antiseptic management. Anaerobic and gram-negative flora is isolated. The size and location of the intrapleural cavity being cured are assayed by CT, thoracic ultrasonography and fistulography. In none of the patients is clinical and FBS evidence of bronchopleural fistula established. The operative procedure consists in resection of a 4 cm segment from the underlying rib in the drainage zone, and further cavity treatment under thorascopic control. Minor median laparotomy and skeletization of the greater omentum are performed preserving a major nutrient vessel depending on the location of the cavity. The omentum is drived into the pleural cavity through a parietal opening of the diaphragm, measuring 3-4 fingerbreadths. Pleural cavity drainage is carried out according to Redon. Two patients run an uneventful postoperative course. One female patient develops pylorospasm successfully cured by spasmolytic therapy and H2 blockers. CT and thoracic echography do not show presence of residual cavities. The patients are free of any complaints over periods ranging from 6 to 16 months postoperatively. The inference is reached that omentoplasty is a new method promoting successful elimination of both postpulmonectomy empyema, and other residual pleural cavities as well, with or without bronchopleural fistula.
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236
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Tuncozgur B, Ustunsoy H, Sivrikoz MC, Dikensoy O, Topal M, Sanli M, Elbeyli L. Intrapleural urokinase in the management of parapneumonic empyema: a randomised controlled trial. Int J Clin Pract 2001; 55:658-60. [PMID: 11777287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
We compared the effectiveness of intrapleural urokinase versus normal saline via a thoracostomy tube in the treatment of parapneumonic empyema in a randomised controlled study. Forty-nine patients with parapneumonic empyema were randomly assigned to receive either intrapleural urokinase or normal saline treatment. The daily volume instilled through a chest tube was 100 ml in both groups. Urokinase (100,000 IU/day) was diluted in normal saline before instillation. The mean duration for defervescence was shorter (7 +/- 3 vs 13 +/- 5 days, p<0.01) and the mean volume of drained fluid during the five-day treatment period was significantly greater in the urokinase group (1.8 +/- 1.5 vs 0.8 +/- 0.8 litres, p<0.001) than in the control group. The subsequent decortication rate was 60% and 29.1%, respectively (p<0.001). The duration of hospitalisation was also shorter in the urokinase group (14 +/- 4 vs 21 +/- 4 days, p<0.001) than in the saline group. We conclude that intrapleural instillation of urokinase in the management of parapneumonic empyema provides a better outcome and reduces the need for decortication.
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Affiliation(s)
- B Tuncozgur
- Department of Cardiothoracic Surgery, Gaziantep University School of Medicine, Turkey
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237
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Yuen KY, Woo PC, Teng JL, Leung KW, Wong MK, Lau SK. Laribacter hongkongensis gen. nov., sp. nov., a novel gram-negative bacterium isolated from a cirrhotic patient with bacteremia and empyema. J Clin Microbiol 2001; 39:4227-32. [PMID: 11724825 PMCID: PMC88529 DOI: 10.1128/jcm.39.12.4227-4232.2001] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A bacterium was isolated from the blood and empyema of a cirrhotic patient. The cells were facultatively anaerobic, nonsporulating, gram-negative, seagull shaped or spiral rods. The bacterium grows on sheep blood agar as nonhemolytic, gray colonies 1 mm in diameter after 24 h of incubation at 37 degrees C in ambient air. Growth also occurs on MacConkey agar and at 25 and 42 degrees C but not at 4, 44, and 50 degrees C. The bacterium can grow in 1 or 2% but not 3, 4, or 5% NaCl. No enhancement of growth is observed with 5% CO(2). The organism is aflagellated and nonmotile at both 25 and 37 degrees C. It is oxidase, catalase, urease, and arginine dihydrolase positive, and it reduces nitrate. It does not ferment, oxidize, or assimilate any sugar tested. 16S rRNA gene sequencing showed that there are 91 base differences (6.2%), 112 base differences (7.7%), and 116 base differences (8.2%) between the bacterium and Microvirgula aerodenitrificans, Vogesella indigofera, and Chromobacterium species, respectively. The G+C content (mean and standard deviation) is 68.0% +/- 2.43%, and the genomic size is about 3 Mb. Based on phylogenetic affiliation, the bacterium belongs to the Neisseriaceae family of the beta-subclass of Proteobacteria. For these reasons, a new genus and species, Laribacter hongkongensis gen. nov., sp. nov., is proposed, for which HKU1 is the type strain. Further studies should be performed to ascertain the potential of this bacterium to become an emerging pathogen.
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Affiliation(s)
- K Y Yuen
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
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238
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Gavazzi G, Orliaguet O, Coume M, Lamloum M, Debray M, Couturier P, Franco A. [Thoracic empyema in very old patients: two types of clinical presentation]. Rev Med Interne 2001; 22:1124-7. [PMID: 11817125 DOI: 10.1016/s0248-8663(01)00478-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Primitive thoracic empyema or empyema secondary to pneumonia represents a significant medical problem necessitating prolonged hospitalizations and increasing the rates of morbidity and mortality. Average patient age is 55 years and remains rare in very old patients (> 85). We report here two observations in very old patients, pointing out the diversity of the clinical presentation. EXEGESIS Empyema thoracis is classically associated with underlying diseases. It is often polymicrobial but Gram-positive bacteria and anaerobes are more frequent than Gram-negative bacteria. The clinical presentation may be aspecific without any parameters in favor of infectious disease: the rapidity of pleural drainage and antibiotic therapy are the main prognostic factors. CONCLUSION Because of the diversity of clinical presentation in the elderly population, and because of the efficiency of rapid treatment, geriatric physicians should perform an examination of pleural fluid when pleural effusion is unknown.
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Affiliation(s)
- G Gavazzi
- Service de médecine interne et de gérontologie clinique, département de médecine communautaire, hôpital A.-Michallon, CHU, 38000 Grenoble, France.
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239
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Laserna Martínez E, Luque Márquez R, Ruiz García A. [Spontaneous bacterial empyema caused by Enterococcus faecalis in a cirrhotic patient without ascites]. Arch Bronconeumol 2001; 37:404. [PMID: 11674943 DOI: 10.1016/s0300-2896(01)78824-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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240
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Alonso Fernández A, Alvarez-Sala Walter R, Prados Sánchez C, Mayoralas Alises S, Villamor León J. [Community-acquired empyema caused by Acinetobacter baumannii]. An Med Interna 2001; 18:529-30. [PMID: 11766283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We referred a fourty-four years old male, without interesting personal history and who was accepted in the hospital due to dyspnea and fever and who was diagnosed with empyema by Acinetobacter baumannii acquired in the community; we have found no references about this in the medical literature.
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241
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Abstract
The aim of this study was to evaluate the effect of preoperative delay on the efficacy of video-assisted thoracoscopic surgery (VATS) for post-pneumonic pleural empyema (PPE). This was a prospective study of 39 consecutive patients with PPE who were treated by VATS with curative intent over a 4-year period. Failure to obtain full lung re-expansion resulted in conversion to thoracotomy. Pre- and post-operative variables were correlated with surgical outcome. VATS debridement was successful in 16 (41%) patients while conversion to open decortication was needed in 23 patients (21 immediate, two delayed), There was no difference in the age/sex distribution of the two groups. In the failed VATS group the delay from hospital admission to operation was longer: 24 (2.1) vs. 16.6 (2.7) days (P = 0.03, 95% CI 0.53-14.3 days); operating time was longer: 128.2 (7.9) vs. 86.2 (10.4) min (P = 0.003, 95% CI 15.2-68.5 min) and post-operative stay was longer: 8.4 (0.8) vs. 5.2 (0.6) days (P = 0.03, 95% CI 1.1-5.3 days). VATS can be used successfully to treat PPE with a faster post-operative recovery when successful than open surgery. Delayed surgical intervention decreases the success of VATS thus earlier referral for surgical intervention in PPE (ideally within 21 days) is advocated to gain its full benefits.
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Affiliation(s)
- D A Waller
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
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242
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Córdoba López A, Inmaculada Bueno Alvarez-Arenas M, Monterrubio Villar J, Corcho Sánchez G. [Pleural empyema caused by Flavimonas oryzihabitans in a healthy male]. Med Clin (Barc) 2001; 117:277-8. [PMID: 11562334 DOI: 10.1016/s0025-7753(01)72085-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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243
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Paganini H, Guiñazú JR, Hernández C, Lopardo H, Gonzalez F, Berberian G. Comparative analysis of outcome and clinical features in children with pleural empyema caused by penicillin-nonsusceptible and penicillin-susceptible Streptococcus pneumoniae. Int J Infect Dis 2001; 5:86-8. [PMID: 11468103 DOI: 10.1016/s1201-9712(01)90031-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To describe the clinical characteristics of pleural empyema in children caused by Streptococcus pneumoniae nonsusceptible to penicillin and compare their clinical outcome with pleural empyemas caused by penicillin-susceptible organisms. METHODS Records of 109 children with complicated pleural effusions between January 1996 and December 1998 were retrospectively reviewed. RESULTS Pathogens were recovered in 45 of these cases. Streptococcus pneumoniae represented 71% of the isolates, with 20 (62%) and 12 (38%) of the strains proving susceptible and nonsusceptible to penicillin, respectively. The average age for children with penicillin-nonsusceptible infections was 18.3 months compared with an average age of 40.9 months for those with penicillin-susceptible infections (P = 0.03). Previous antibiotic treatment was more frequent in children with penicillin-nonsusceptible organisms (P = 0.05). No significant differences were found between the two groups for gender, underlying diseases, duration of fever and tachypnea, need of surgical treatment, bacteremia incidence, mean duration of therapy, or length of hospital stay. CONCLUSIONS Pleural empyemas caused by penicillin-nonsusceptible S. pneumoniae appear to be associated with younger age and previous antibiotic treatment. By contrast, the outcome was not influenced by the penicillin susceptibility of the pneumococcus strains.
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Affiliation(s)
- H Paganini
- Department of Infectious Diseases and Epidemiology, Hospital de Pediatría Profesor Dr. Juan P. Garrahan, Buenos Aires, Argentina.
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244
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Hoyler SL, Antony S. Eikenella corrodens: an unusual cause of severe parapneumonic infection and empyema in immunocompetent patients. J Natl Med Assoc 2001; 93:224-9. [PMID: 11446395 PMCID: PMC2594019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Over the past 25 years, Eikenella corrodens has increasingly been recognized for its pathogenic potential. Previously identified as an organism most likely to cause opportunistic infection in the immunocompromised host, Eikenella more recently has been implicated in a number of clinical infections in non-immunocompromised patients. We report a case of community-acquired pneumonia, caused by Eikenella, in a patient with diabetes mellitus and a past history of testicular cancer. A review of the literature was conducted in order to review other cases of pulmonary infection with Eikenella, in immunocompetent adults. The condition was diagnosed in 15 patients, occurring most often in men with a mean age of 50. Patients most often presented with fever, cough and pleuritic chest pain. Complications often involved parapneumonic effusion, empyema, and necrotic parenchymal disease. Mortality rates appear to be low. Eikenella is most often susceptible to ampicillin and has variable susceptibility to aminoglycosides. The addition of clindamycin in non-immunocompromised patients with Eikenella infection, co-infected with other pathogens, also appears to be useful. Surgical intervention plays an important role in the recovery of these patients.
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Affiliation(s)
- S L Hoyler
- University of Texas at Austin College of Pharmacy, Texas Oncology Physicians Associates, El Paso 79915, USA
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245
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Berdonces P, Echeverría MJ, Mendoza F, López De Goicoechea MJ, Ayarza R. [Empyema due to Salmonella enterica serotype enteritidis]. Enferm Infecc Microbiol Clin 2001; 19:238. [PMID: 11446917 DOI: 10.1016/s0213-005x(01)72623-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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246
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Blanco Pérez JJ, Pérez García M, Paz Vidal I. [Pleural empyema and pericardial effusion due to Campylobacter fetus in an immunocompetent adult]. Arch Bronconeumol 2001; 37:217-8. [PMID: 11412511 DOI: 10.1016/s0300-2896(01)75056-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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247
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Canet JJ, Hernández R, Almagro P, Garau J. [Pleural empyema due to Gemella morbillorum]. Enferm Infecc Microbiol Clin 2001; 19:189. [PMID: 11333615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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248
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249
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Kanungo R, Kumar A, Srinivasan S, Badrinath S. Pleural empyema due to group B Salmonella in a child with diarrhea. Indian Pediatr 2001; 38:186-9. [PMID: 11224587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- R Kanungo
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605 006, India
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250
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Osada T, Nagawa H, Masaki T, Tsuno NH, Sunami E, Watanabe T, Muto T, Shibata Y. Thoracic empyema associated with recurrent colon cancer: report of a case and review of the literature. Dis Colon Rectum 2001; 44:291-4. [PMID: 11227950 DOI: 10.1007/bf02234308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Many types of infections associated with colorectal cancer have been reported. Here, we describe a rare case of thoracic empyema that was observed during immunotherapy for recurrent colon cancer. Culture of the pleural fluid yielded Streptococcus bovis, which is known to be associated with gastrointestinal lesions, especially colorectal malignancies. The possible correlation between these two clinical entities-empyema and colon cancer-is discussed.
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Affiliation(s)
- T Osada
- Department of Surgical Oncology, Graduate School of Medicine, the University of Tokyo, Japan
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