PubMed · 6122015
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1982-03-27. Thoracic empyema.. https://pubmed.ncbi.nlm.nih.gov/6122015/
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Before World War II, it was not uncommon for a person with influenza caused by streptococcus to develop empyema. Retired surgeon Harry Morton recalls two well-known patients who had empyema-related operations outside the hospital.
A 62-year-old woman suffered right empyema caused by methicillin-resistant staphylococcus aureus (MRSA) which occurred following a pancreatico-duodenectomy. After open drainage thoracotomy, intrathoracic transposition of the extended musculocutaneous (MC) flap of the latissimus dorsi was performed. The patient is now in good health, without recurrence of either the empyema or the carcinoma, 19 months after the operation. The MC flap, compared to muscle flap, has the advantages that (1) larger empyema cavities can be obliterated, and (2) the deformity of the thoracic wall can be minimized, because of the small range of resected rib segments and well-preserved volume of subcutaneous tissue in the flap long after transposition.
A 54-year-old female diabetic patient who had been under regular oral hypoglycemic agent control for 2 years was admitted because of having dyspnea and orthopnea for several days. Massive pericardial effusion and a moderate amount of bilateral pleural effusion were noted at the time of admission. Pericardiocentesis and thoracocentesis were performed; both cultures grew Salmonella typhimurium. Antibiotic therapy was started immediately, but pleural effusion persisted. After repeated thoracocentesis and pleural effusion drainage, the patient was discharged 51 days later with complete recovery. Pericarditis and empyema are rare complications of Salmonella infections. Coexistence is even more rare, and only three cases have been reported in the English literature. Therefore, this case is presented with a review of the previous literature followed by discussion.