Improved survival in management of empyema thoracis

摘要: Empyema thoracis following pneumonia, trauma, and surgical procedures continues to be a source of major morbidity mortality. We retrospectively reviewed the hospital records 100 patients treated for empyema at San Francisco General Hospital during past 10 years. The causes in these were as follows: pneumonia 44%, trauma 24%, invasive 15%, lung abscess 11%, hematogenous spread 6%. Ten this series died sepsis from necrotizing or overwhelming injuries caused by trauma. Streptococcus (31%), Staphylococcus (21%), Bacteroides (15%) organisms most commonly isolated. Bacterial isolates single 55%, multiple 42%, absent 3%. type organism did not correlate with severity disease eventual requirement thoracotomy, pleural debridement, Eloesser procedure. Successful methods treatment included aspiration 9%, tube thoracostomy 63%, debridement drainage 7%, an procedure 11%. Because our often debilitated chronic alcoholism, drug addiction, conservative management was initially tried. In resolved thoracostomy. Pleural should reserved special problems such loculation purulence inaccessible percutaneous placement. is indicated who have infected residual space that persists despite adequate drainage.