Delayed postpneumonectomy empyema.

Abstract

OBJECTIVE: Most postpneumonectomy empyemas occur shortly after the surgery, but rarely do they manifest much later. We present our experience in treating two cases of delayed postpneumonectomy empyema and discuss its clinical features. EXPERIMENTAL DESIGN: The diagnosis of delayed empyema is difficult as patients present with nonspecific symptoms. Consequently, there was a delay of several weeks in reaching the correct diagnosis. This is a retrospective case study of two patients. SETTING: The patients were admitted to hospital for appropriate care. PATIENTS: Two patients were diagnosed as having delayed postpneumonectomy empyema from consequential infection. Chest X-ray may provide helpful information such as the presence of air-fluid level or a mediastinal shift toward the remaining lung (by accumulation of pus in the postpneumonectomy cavity). INTERVENTION: The patients were treated surgically. RESULTS: In both cases the diagnosis of postpneumonectomy empyema was delayed, but eventually correct diagnosis was made. The outcome of the surgical therapy was successful. CONCLUSIONS: Delayed postpneumonectomy empyema is a rare condition. The etiology in the majority of cases is probably due to hematogenous spread of bacteria from other parts of the body. Correct diagnosis of this condition is often delayed. The treatment is surgical.