Optimal management of complicated empyema

Management of postpneumonic empyemas in children

“…Delays in accurate diagnosis and, thus, effective management, can prolong the patient's illness and result in the need for extensive surgical interventions [9]. As a result, the optimal therapeutic approach to complicated empyema has yet to be defined, and most likely depends on accurate staging of the pleural disease [10]. The aim of this study is to assess different treatment options in the management of postpneumonic pediatric empyemas.…”

Thoracic empyema, application of video-assisted thoracic surgery and its current management

“…Some authors have advised that medical management alone will resolve most empyemas; however, several studies clearly demonstrate that this occurs at the cost of prolonged antibiotic therapy, increased number of diagnostic studies and hospitalization, even if interventions are performed after medical failures [6,[15][16][17]. Thus, optimal timing of surgical intervention affects clinical outcome.…”

Empyema Thoracis Caused by Drug-Resistant Staphylococcus aureus in an Adult Female: A Case Report

“…Complicated parapneumonic effusion or pleural empyema develops in 10-20% of outpatients with pneumonia [2]. Empyema thoracis has been traditionally categorized based on three clinical phases: exudative, fibrinopurulent, and organizing [3][4][5]. The initial diagnosis is made after a thorough history and physical exam to delineate the start of symptoms and prior antibiotic treatments.…”

“…The management of empyema thoracis usually depends on the clinical phase. Multiple therapeutic options are available for the management of empyema: antibiotherapy, thoracentesis, closed (tube) thoracostomy, image-guided catheter drainage, and decortication; however, the optimal therapeutic management has not been elucidated [3,4]. Decortication is more frequently necessary for anaerobic, tuberculous, staphylococcal, and pneumococcal infections [4].…”