Diagnostic Problems in Suppurative Lung Disease

Schachter, E. Neil

doi:10.1001/archinte.1976.03630020023007

Cited by 23 publications

(1 citation statement)

References 14 publications

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“…Radiographic evaluation includes 1) CXR(F+P), bilateral decubitus films (free flowing /loculated empyema), assesses the completeness of drainage and lung expansion, 2) ultrasound to identify loculations/ pleural fibrosis, offers guidance for choosing site of thoracentesis and has the ability to differentiate between transudative and exudative effusions. 3) CT chest reveals the "split pleura" sign in nearly 70% of empyemas, identifies septations the total amount of pleural fluid, calculate the Hounsfield unit value, assesses the completeness of drainage and lung expansion [6][7][8]. We report our experience with 12 patients during the lockdown period in Greece that spanned from March till June of 2020 in an attempt to highlight the importance of early and adequate intervention in order to avoid extensive procedures and dreaded complications.…”

Section: Introductionmentioning

confidence: 99%

Occurrence and Management of Empyema Thoracis During Covid-19 Times

Christina¹,

Thrasyvoulos²,

Nikoleta³

et al. 2020

SCR

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Introduction: Empyema is defined as an infected pleural fluid collection, evidenced either by purulent fluid or the presence of bacterial organisms. The aim of this study is to highlight the importance of early diagnosis and management of empyema in an attempt to avoid needless procedures and dreaded complications while shining a light into the warrant of a multidisciplinary approach that would had a paramount significance during the lockdown period in Greece, between March-June of 2020 due to COVID-19, in ameliorating those issues. Patients and Methods: During the aforementioned period 12 patients were treated at our Department, 11 of them were male, ages ranging from 22-71 years old. The cause of empyema was parapneumonic effusion from a bacterial pneumonia in 10 patients and the other 2 were tuberculous empyema and extension of an intraabdominal process (Diffuse large B-cell lymphoma of the stomach). Predominately the patients were admitted to our Department with stage III empyema. Diagnosis was confirmed with CT scan and drainage of frank pus from the chest tube. All patients underwent chest tube insertion and antibiotic therapy nonetheless 9 of them required surgical management with VATS or open decortication. Results and Conclusion: The impedance in seeking medical advice due to fear of COVID-19 and the insufficiency of an interdisciplinary approach in the management of those patients were determined as the reason for such high admittance with stage III empyema. The decision of open vs VATS decortication was made based on the medical status and history of each individual, the stage of the empyema and ultimately our ability to achieve the two primary goals of empyema treatment, complete evacuation, and lung reexpansion [1]. Eight patients underwent open decortication and drainage and one managed with VATS decortication. Postoperative complications were encountered in 3 patients which included prolonged air leak, surgical wound infection, and septic shock. One patient died from multiple organ failure due to postoperative septic shock. The duration of chest tube drainage varied from 5-15 days. The mean hospital stay was 13,5 days.

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Section: Introductionmentioning

confidence: 99%

Occurrence and Management of Empyema Thoracis During Covid-19 Times

Christina¹,

Thrasyvoulos²,

Nikoleta³

et al. 2020

SCR

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Aspiration of Intrathoracic Abscess

Reeder¹

1978

JAMA

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Three cases illustrate that acute respiratory failure may be precipitated by spontaneous drainage of lung abscess or pleural empyema intrabronchially with diffuse aspiration of the contents bilaterally. This condition is especially hazardous if the cavity is large and the patient is debilitated or obtunded. The acute onset may mimic aspiration of gastric contents. Immediate studies of tracheal aspirate and roentgenograms of the chest should define the aspiration of intrathoracic abscess contents as the cause of acute respiratory failure.

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