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At least 19 recordsLinked to original sources

PubMed1977

Computed tomography (CT) in the diagnosis of intracranial abscesses. Brain abscess, subdural empyema, and epidural empyema.

Nine cases of brain abscess, five of subdural empyema, and one of epidural empyema with associated subdural empyema were identified using computed tomography (CT). Smal and multiple abscesses as well as unilateral, bilateral, and parafalcine empyemas were detected. These lesions were demonstrated rapidly and accurately, even in areas that are demonstrated poorly by other diagnostic techniques. No false-negative studies were found in cases of brain abscess or subdural empyema. However, since the appearance of brain abscesses of CT scans is similar to that of neoplastic and vascular lesions, false-positive reports of brain abscess were encountered.

Brain Abscess↗

PubMed1978

Management of empyema thoracis: report of a 3-year study.

Experience with cases of empyema thoracis in Nigerian adults is reported. Twenty-seven patients with empyema diagnosed on aspiration of the chest were studied. The clinical features, the radiolographic appearance and the results of laboratory studies carried out on the patients were analysed. Micro-organisms were cultured from the pleural fluid in 41% of cases. In this study, the commonest cause of empyema was pneumonia, occurring in 48% of cases, closely followed by tuberculosis with 40%. No death was recorded among cases of empyema due to pyogenic and tuberculous organisms. This is due to increased awareness of the cause and the methods of treatment applied. The author is of the opinion that cases of tuberculous empyema are being misdiagnosed and, consequently, they are not given appropriate chemotherapy, and this might have contributed to the high mortality rate previously reported.

Adolescent↗

PubMed1978

Duration of hospitalization for acute bacterial empyema at Boston City Hospital during 12 selected years from 1935 to 1972.

The duration of hospitalization for acute bacterial empyema of the pleura was determined for all cases at Boston City Hospital during 12 selected years between 1935 and 1972. Patients whose infection was acquired after admission stayed in the hospital longer than those in whom the empyema, or the infection of which the empyema was a complication, was present at the time of admission. The differences were mostly related to serious underlying disease in the hospital-acquired cases. However, the duration of hospitalization after the empyema was bacteriologically confirmed was not much different in the community-acquired and hospital-acquired cases. Hospital stay was further prolonged in patients whose empyema was superinfected with new bacterial species after the original infecting organisms were determined. Hospitalization was shorter in the 10 selected years between 1974 and 1972, when penicillin and other active antibiotics were used, than in two years before penicillin became available, 1935 and 1941.

Acute Disease↗

PubMed2026

Metagenomic Next-Generation Sequencing for the Diagnosis of Trichomonas Vaginalis-Associated Empyema: a Case Report and Literature Review.

BACKGROUND: This report describes a rare case of empyema caused by Trichomonas vaginalis co-infected with Streptococcus agalactiae and Streptococcus pyogenes, aiming to explore the role of T. vaginalis in the development of empyema, its diagnostic methods, and treatment strategies. METHODS: The patient was a 46-year-old male who presented with cough, sputum production, and shortness of breath. The diagnosis was made using chest CT, routine pleural fluid analysis, bacterial culture, and metagenomic next-generation sequencing (mNGS). Pleural fluid examination revealed numerous motile Trichomonas organisms, and bacterial culture identified Streptococcus agalactiae and Streptococcus pyogenes as the pathogens. Fur-ther mNGS confirmed these bacteria as the causative agents, with 39 Trichomonas sequences detected, including 32 sequences specific to T. vaginalis. RESULTS: The patient received combination antimicrobial therapy and underwent chest tube drainage and thoracoscopic empyema debridement. Post-treatment, the patient's condition significantly improved. A literature review revealed that while Trichomonas tenax is a common pathogen in empyema, T. vaginalis is an extremely rare cause. T. vaginalis infection may be associated with bacterial co-infections, immunosuppression, or poor hygiene. CONCLUSIONS: This case is the first report of T. vaginalis induced empyema, expanding the understanding of Trichomonas infections. Although such infections are rare, they should be considered in high-risk patients. Further studies are needed to investigate the infection pathways of T. vaginalis and its mechanisms of bacterial synergy in disease pathogenesis to improve clinical diagnosis and treatment strategies.

Humans↗

PubMedDate not supplied

[Pleural empyemas in children due to Hemophilus influenzae].

22 consecutive cases of pleural empyema due to H. influenzae in children are reported. An increment of its incidence during the 1975-76 period is observed. All cases were in children under 3 years of age, with a mean of 15.5 months. The presenting syndrome at admission was varied. In 50% of cases, pleuropulmonary infection was ignored. Nearly one half of cases of pleural empyema due to H. influenzae had simultaneous purulent meningitis caused by the same microorganism. This type of empyemas, though having a prolonged evolution, apparently appear to have a good prognosis, compared with that produced by S. aureus. There are some differences, being the most outstanding: low frequency of pyoneumothorax and the lack of radiological evidences of abscesses and or pneumotoceles, in any phase of the clinical course. Stress is placed on the value of the bacteriological study of blood and CSF in children under 3 years of age with pleural empyema. A high rate of positive blood cultures was found. (75%). Pieuropulmonary complications, as a frequent event during severe infections (septicemic disease) due to H. influenzae is considered. A clinical characterization of children in whom a pleural empyema could occur is proposed. A discussion is made about diagnostic, therapeutic and prognostic implications of these complications.

Cerebrospinal Fluid↗

PubMed1978

Pneumococcal empyema in childhood.

Two serotypes, uncommon in pediatric infections, accounted for a disproportionately large number of cases of pneumococcal empyema at the Children's Hospital of Pittsburgh. Eight of ten empyemas were caused by types 1 or 3, and two additional cases of mixed infection involved the type 3 pneumococcus. The type 3 pneumococcal empyemas tended to be more severe than those due to other serotypes. Counterimmunoelectrophoresis (CIE) appeared to be more useful than culture in establishing the cause of this condition; in seven of ten cases, the pleural fluid was CIE positive while cultures of blood and pleural fluid were negative. In each of the seven culture-negative cases, antibiotics had been given prior to hospitalization. One case of type 7 pneumococcal empyema illustrated the potential value of the Ouchterlony test for the etiologic diagnosis of this condition.

Child↗

PubMed1977

Salmonella empyema: a review.

A 35-year-old man developed salmonella pleural empyema during a three-month illness. Cultures of the empyema fluid yielded S enteritidis, serotype typhimurium. Cure was achieved by decortication and obliteration of the pleural empyema space, in combination with chloramphenicol therapy given parenterally. Review of the published reports revealed eight similar instances of salmonella empyema. Manifestations and treatment of this group are reviewed.

Adult↗

PubMed1979

Treatment of postpneumonectomy empyema: the case for fenestration.

In Mearnskirk Hospital, Glasgow, 29 patients with postpneumonectomy empyema were treated by fenestration in a 12-year-period. Seven of these were not considered fit enough for definitive closure and died of continuing disease or respiratory infection. Twenty-two patients went on to closure of their fenestra, and in 17 (77%) the pneumonectomy space was rendered permanently sterile. If the empyema recurred treatment was repeated but proved less successful. Fenestration is an effective method of dealing with postpneumonectomy empyema, but also has several other advantages, particularly if the empyema is associated with a bronchopleural fistula.

Adult↗

PubMed1977

The syndrome of inappropriate secretion of antidiuretic hormone associated with anaerobic thoracic empyema.

The syndrome of inappropriate secretion of antidiuretic hormone has been associated with many pulmonary diseases, including tuberculosis and bacterial and viral pneumonia: however, it has not been reported with anaerobic infections or empyema in the absence of pneumonia. We report a patient with empyema due to Bacteroides melaninogenicus, Bacteroides oralis, and Peptostreptococcus who developed the syndrome. Eight hours before the start of therapy, his serum sodium concentration was 127 mEq per liter; serum osmolality, 255 mOsm per kg; urine osmolality, 522 mOsm per kg; urinary sodium concentration, 39 mEq per liter. The creatinine clearance and the adrenocorticotropic hormone stimulation test were normal, and there was no evidence of dehydration. No other causes of the syndrome of inappropriate secretion of antidiuretic hormone were apparent. With drainage and antimicrobial drug therapy, the empyema cleared, and the syndrome resolved in 8 days. The patient has been well, without evidence of inappropriate secretion of antidiuretic hormone, for 9 months. Anaerobic infections and/or empyema without pneumonia can be associated with the syndrome of inappropriate secretion of antidiuretic hormone.

Adult↗

PubMedDate not supplied

[Surgical treatment of empyema (with or without bronchial fistula) after pneumonectomy].

The therapeutical possibilities are discussed in the most severe of the complications of pneumectomy : empyema, with or without bronchial fistula. The value was demonstrated of the thoraco-mediastinal plicature in the solution of 21 cases of empyema (of which 6 had bronchial fistula) occuring after pneumectomies performed for bronchopulmonary cancers (10 patients), pulmonary tuberculosis (8 patients) and broncho-pulmonary suppurations (3 patients). The results obtained were very satisfactory in 19 cases while in the other two cases the cure of the empyema was achieved although the patients died as a result of the evolution of the basal disease (bronchopulmonary cancer).

Bronchial Fistula↗

PubMed1979

[Results of continuous suction drainage in the treatment of pleural empyema (author's transl)].

201 adults with non-specific pleural empyema (58 women, 143 men) had suction drainage. Most of the patients were aged 61-70 years. In the 47 patients who had not had antibiotic therapy before admission the main causal micro-organisms were staphylococci, pneumococci and streptococci; in the 149, who had had antibiotic therapy outside, micro-organisms such as Pseudomonas, Esch. coli and Proteus predominated. Suction drainage had to be kept up for a remarkably long time: for 4-8 weeks in 36% of the cases and for more than 8 weeks in 8%. 31 patients died, but only 17 of them as a direct result of the pleural empyema. They had all been "high risk" cases on account of age (average 67.7 years), type of bacteria (59%), serious primary or complicating disease (59%), duration of the pleural empyema (76%). Suction drainage succeeded in 140 patients in clearing the infection; but marked adhesions were demonstrable in 27% of the patients when they were discharged from hospital.

Adult↗

PubMed1979

[Therapy of pleural empyema after pneumonectomy with open-window drainage and continuous rinsing].

From 1961 to 1977 24 thoracic empyemas (=4,75%) after 507 pneumonectomies were observed at the Surgical Clinic A of the Zurich University Hospital. Two methods for the management of this condition are discussed: open-window drainage (CLAGETT) and continuous rinsing of the pleural cavity (LUIZY). The first mentioned method proved to be a palliative one in our patients: no thoracostomy could be re-closed operatively. Two thoracic windows healed up spontaneously without recurrence of an empyema; one patient died shortly after the operation from respiratory insufficiency. Of the five patients treated by continuous rinsing, four were cured as for their empyema, but one of the latter died from renal insufficiency. In one case an open-window drainage finally had to be accomplished.

Adult↗

PubMed1978

Spinal epidural empyema with the Brown-Séquard syndrome.

A patient with an acute onset of the Brown-Séquard syndrome, in whom the etiology was a painless thoracic epidural empyema, is discussed. The case is a unique presentation for spinal epidural empyema and presents a rare extramedullary cause of the Brown-Séquard syndrome. Pertinent literature for spinal epidural empyema is reviewed.

Aged↗

PubMed1975

Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature.

Anaerobic bacteria were isolated from the subdural space in all four cases of subdural empyema encountered over a 2 and a half year period. Only one aerobe was isolated in these cases. The bacteriology of subdural empyema was further analyzed from a review of 327 cases reported in the English literature. Anaerobes accounted for 12 per cent of 234 cases; In addition, 27 per cent of cases were reportedly "sterile." These data support our finding that anaerobic bacteria may play a far more important role in subdural empyema than was previously appreciated.

Adolescent↗

PubMedDate not supplied

Subdural empyema in Africans in Rhodesia.

Subdural empyema was encountered in 44 African patients in Rhodesia during the period from 1970 to 1974. Subdural empyema seems to be a relatively frequent occurrence in Africans. Sixty-eight per cent of the patients were below the age of 20 years, and males predominated. More than half of the patients had either a history or evidence of an infectious process outside the central nervous system, and about 60% demonstrated focal neurological signs. The diagnosis was confirmed by either surgery or postmortem examination. Cultures of available specimens were positive in 50%. The predominant organisms identified were Streptococcus, followed by Staphylococcus. Surgical treatment consisted mainly of multiple burr holes, drainage of the empyema, and irrigation. The mortality rate in this study was 59%, and some recognizable contributing factors are elaborated. In the discussion the authors compare these observations with pertinent reviews from the literature. Some of these findings correlate well with other reports, whereas other observations are attributed to factors partly inherent in the socio-economic structure of the African population in Rhodesia.

Adolescent↗

PubMed1979

Subdural interhemispheric empyema in a 7-year-old boy.

Subdural interhemispheric empyema was diagnosed by angiography and computerized tomography (CT) in a 7-year-old boy suffering from acute left hemiparesis. After neurosurgical intervention his condition improved. Peptostreptococcus intermedius was cultured from the empyema. One year after hospitalisation the boy is in good condition. The importance of the CT-scanning for diagnosis and management of brain abscess or empyema is stressed.

Brain Abscess↗

PubMed1975

Necrotizing pneumonia and empyema due to Clostridium perfringens. Report of a case and review of the literature.

Clostridia are rare causes of pleuropulmonary infections in the absence of penetrating chest injuries; only 10 previous cases have been reported from civilian practice. An additional case of a rapidly progressive, necrotizing pneumonia and empyema is reported. Clostridial pneumonia is more likely to occur in patients with underlying pleuropulmonary disease. Unlike clostridial myonecrosis, it is rarely associated with toxemia; its mortality rate is comparable to that of nonclostridial pleuropulmonary infections. Appropriate antimicrobial therapy with surgical drainage of the empyema is the treatment of choice. Among the cases reviewed, an iatrogenic cause of infection involving an invasive procedure into the pleural cavity could be identified in seven of 11 cases. Aspiration of oropharyngeal contents was the likely route of infection in three other cases. In the remaining case, bacteremic seeding of the pleural cavity was the most probable mode of infection.

Clostridium Infections↗

PubMed1979

The etiology of post-traumatic empyema and the role of decortication.

Decortication post-traumatic empyema (PTE) was performed in 27 patients from 1972 through 1977. All 27 patients had penetrating chest wounds and were refractory to antibiotics and tube thoracostomy. Factors associated with PTE included unrecognized diaphragmatic perforation, large hemothorax greater than 500 ml, pulmonary contusion, extrathoracic extension of hematoma within the chest wall, and incomplete expansion of the lung with initial tube thoracostomy. Prophylactic antibiotic usage did not prevent PTE nor lead to negative intrapleural cultures preoperatively. The timing of decortication varied with indication: two patients with infected pneumothorax had surgery within 1 week; 15 patients with infected pleural clot had surgery within 4 weeks; ten including nine who were readmitted to the hospital had surgery more than 4 weeks after injury. Prevention of PTE requires early recognition of hemo- or pneumothorax, early tube thoracostomy with complete evacuation of blood and expansion of lung, careful daily monitoring of subsequent fluid accumulation, and prompt evacuation when such fluid accumulates. Once PTE becomes well established and refractory to standard modalities, decortication with evacuation of the empyema cavity should be performed as soon as possible.

Adolescent↗