639 results match your criteria: "Parapneumonic Pleural Effusions and Empyema Thoracis"
Beyond diagnosis: maximizing the role of medical thoracoscopy in pleural disease treatment.
Respir Res
November 2024
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Article Synopsis
- * It helps with thoracic drainage, which can shorten hospital stays for patients with complicated effusions and empyema, and can be used for treating pneumothorax and other conditions.
- * Despite its potential, there are no standardized protocols for certain treatments, and more quality clinical research is needed to fully confirm its effectiveness in various applications.
Bilateral parapneumonic empyema caused by infection in a healthy individual.
IDCases
October 2024
Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
Article Synopsis
Machine Learning Model Predictors of Intrapleural tPA and DNase Failure in Pleural Infection: A Multicenter Study.
Ann Am Thorac Soc
October 2024
Vanderbilt University Medical Center, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, , Nashville, Tennessee, United States.
Rationale: Intrapleural enzyme therapy (IET) with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has been shown to reduce the need for surgical intervention for complicated parapneumonic effusion/empyema (CPPE/empyema). Failure of IET may lead to delayed care, and increased length of stay.
Objective: The goal of this study was to identify risk factors for failure of IET.
Clinical characteristics and decortication outcomes of bacterial, tuberculous and fungal pleural infection.
Int J Tuberc Lung Dis
November 2024
Division of Thoracic Surgery, Department of Surgery, and, Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
Decortication with uniport video-assisted thoracoscopic surgery for empyema due to postoperative esophageal leakage: a report of two pediatric cases.
Surg Case Rep
October 2024
Department of Pediatric Surgery, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
Background: Video-assisted thoracoscopic surgery (VATS) is considered useful for the treatment of parapneumonic empyema in children. However, thoracoscopic management of empyema due to esophageal leakage as an operative complication has not been well described in the literature.
Case Presentation: We successfully decorticated severe empyema using uniport VATS in 2 children (a 2-year-old boy who suffered esophageal perforation after laparoscopic anti-reflux surgery, and a 7-month-old girl who had anastomotic leakage after thoracoscopic repair of esophageal atresia).
[Medical and surgical treatment of parapneumonic effusion].
Rev Med Suisse
October 2024
Service d'infectiologie, HFR Fribourg, 1752 Villars-sur-Glâne.
Article Synopsis
- Pleural empyema is a serious condition characterized by pus accumulation in the pleural space, often a complication of pleural effusion, particularly common in older adults.
- The prognosis for patients with pleural empyema heavily relies on quick diagnosis and treatment, which typically includes antibiotics, draining the excess fluid, and physical therapy.
- The article explores the progression of complicated pleural effusions and discusses various treatment options available for adults, emphasizing that choices depend on individual patient factors.
Diagnostic and prognostic implications of bacteremia in patients with complicated pleural infection.
Pleura Peritoneum
June 2024
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Article Synopsis
- The study investigated the incidence and clinical significance of bacteremia in patients with complicated pleural infections, finding that 7% of the 341 patients had positive blood cultures.
- Blood cultures offered limited additional diagnostic information compared to pleural fluid cultures and did not affect in-hospital mortality rates significantly.
- The only factor closely linked to higher overall mortality was a higher RAPID score, indicating that blood cultures may benefit certain patients, particularly those with cavitary lesions or higher RAPID scores.
ACR Appropriateness Criteria® Workup of Pleural Effusion or Pleural Disease.
J Am Coll Radiol
June 2024
Specialty Chair, University of Chicago, Chicago, Illinois.
Article Synopsis
- Pleural effusions are divided into transudative and exudative types, with transudative ones linked to systemic issues like heart failure and exudative ones often caused by localized problems like infections or tumors.
- This document outlines guidelines for imaging in four clinical scenarios involving suspected pleural effusions, based on the American College of Radiology's evidence-based criteria.
- These guidelines incorporate a systematic review of medical literature and expert opinions to ensure appropriate imaging and treatment recommendations are made, especially when research is limited.
Management of pediatric pleural empyema: a national survey of pediatric surgeons in Brazil.
J Bras Pneumol
May 2024
. Departamento de Clínica Médica, Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.
Objective: To identify how pediatric surgeons manage children with pneumonia and parapneumonic pleural effusion in Brazil.
Methods: An online cross-sectional survey with 27 questions was applied to pediatric surgeons in Brazil through the Brazilian Association of Pediatric Surgery. The questionnaire had questions about type of treatment, exams, hospital structure, and epidemiological data.
Infective Pleural Effusions-A Comprehensive Narrative Review Article.
Clin Pract
May 2024
Department of Internal Medicine, University of Massachusetts Chan Medical School-Baystate Campus, Springfield, MA 01199, USA.
Article Synopsis
- * Radiological techniques like CT scans and ultrasounds are critical for diagnosis, revealing indicators of poor outcomes, while analyzing pleural fluid helps assess disease severity through various biomarkers.
- * Effective management includes 2-6 weeks of antibiotics, drainage of the pleural space, and potentially intrapleural enzymatic therapy, which can enhance recovery but may pose risks such as bleeding.
Empiric Antibiotic Therapy in 1402 Children With Parapneumonic Effusion/Pleural Empyema in Germany: A Long-term Surveillance Study.
Pediatr Infect Dis J
July 2024
Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany.
Article Synopsis
- The study examined antibiotic treatment practices and clinical outcomes in 1,402 hospitalized children with pediatric parapneumonic effusion/pleural empyema from 2010 to 2018 in Germany.
- Although aminopenicillin/beta-lactamase inhibitors and cefuroxime were commonly used, the study found no significant difference in clinical severity or outcomes between these treatments, regardless of whether they were used alone or in combination.
- The findings indicated a trend of antibiotic overtreatment, with a low percentage of patients switching to narrow-spectrum antibiotics despite the identification of specific bacterial pathogens.
Benefit of intrapleural fibrinolytic therapy in the treatment of complicated parapneumonic effusion and empyema.
Pan Afr Med J
April 2024
Abderrahmen Mami Hospital, Intensive Care Unit, Tunis, Tunisia.
Our study aimed to assess the benefit of intrapleural fibrinolysis before resorting to surgery to treat complicated parapneumonic effusion and empyema. We conducted a retrospective and descriptive study, including all patients hospitalized in the intensive care unit (ICU) of the Abderhaman Mami hospital, Tunisia for empyema treated with instillation of intrapleural fibrinolytic therapy between the 1 January 2000 and 31 December 2016. In all patients, empyema was diagnosed on clinical features, imaging findings (chest X-ray, thoracic echography and/or computed tomography (CT), and microbiological data.
View Article and Find Full Text PDFComplications of ultrasound guided very small-bore chest drains for pleural effusions of different etiology.
J Thorac Dis
March 2024
Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden.
Article Synopsis
- - The study evaluated complications from small-bore chest drains used for pleural effusion, focusing on their effectiveness and issues related to different causes of fluid buildup, like malignant PE and empyema.
- - Analyzed data from 484 drains showed high rates of repeat interventions (new drains or surgery) in cases of malignant PE (25.5%) and empyema (56.4%), while simple PE cases had much lower rates (9.5-12.5%).
- - Findings suggest that while small-bore drains are generally effective for simple cases, there are high complication rates for empyema which may necessitate using larger drains and involving surgeons sooner.
Evaluation of the RAPID score as a predictor of postoperative morbidity and mortality in patients undergoing pulmonary decortication for stage III pleural empyema.
Clinics (Sao Paulo)
April 2024
Thoracic Surgery Departament, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Objective: This study aims to correlate the RAPID score with the 3-month survival and surgical results of patients undergoing lung decortication with stage III pleural empyema.
Methods: This was a retrospective study with the population of patients with pleural empyema who underwent pulmonary decortication between January 2019 and June 2022. Data were collected from the institution's database, and patients were classified as low, medium, and high risk according to the RAPID score.
Empyema in children.
Turk Gogus Kalp Damar Cerrahisi Derg
January 2024
Department of Thoracic Surgery, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye.
Article Synopsis
- - Empyema is an infection in the pleural space, often caused by parapneumonic effusion in children, and although antibiotic use has decreased its frequency, it remains a major health issue worldwide.
- - The main treatment goals for empyema are to drain the pleural cavity, treat lung infections with antibiotics, and prevent complications, with strategies varying based on the disease stage.
- - Early detection of childhood empyema leads to high treatment success rates, and children tend to heal more effectively than adults due to their rapid tissue regeneration, allowing for less aggressive treatment options.
Article Synopsis
- Empyema necessitans (EN) is a rare and serious complication of empyema where pus accumulates in the pleural space, leading to abscess formation in the chest wall.
- The case involves an 8-year-old boy who developed EN after incomplete treatment of parapneumonic effusion due to missing a fibrinolytic agent injection, presenting with fever and chest pain.
- Successful management included broad-spectrum antibiotics, video-assisted thoracic surgery, and drainage, emphasizing the need for early diagnosis and effective treatment to prevent complications.
Case report of parapneumonic effusion and mesothelial subdiaphragmatic cyst: relationship or coincidence?
J Int Med Res
March 2024
Department of Pediatrics, Gilbert and Rose-Marie Chagoury School of Medicine and LAU Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon.
Parapneumonic pleural effusions are common in patients with pneumonia. When colonized by pathogenic bacteria or other microorganisms, these effusions can progress to empyema. Additionally, empyema formation may result in extension of the infection into the infradiaphragmatic region, further complicating the clinical scenario.
View Article and Find Full Text PDFDiagnosis and Management of Hepatic Hydrothorax.
Korean J Gastroenterol
February 2024
Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr.Soetomo Teaching Hospital, Surabaya, Indonesia.
Article Synopsis
- - Hepatic hydrothorax is a type of pleural effusion (≥500 mL) that occurs in patients with liver conditions like cirrhosis and portal hypertension, often associated with ascites but can be present without it in some cases.
- - Symptoms commonly include shortness of breath, cough, nausea, and chest pain, with diagnosis confirmed through clinical signs, imaging, and thoracocentesis to rule out other potential causes.
- - Treatment involves managing fluid production and drainage, potentially using techniques like pleurodesis or liver transplantation, as the condition can lead to serious complications like spontaneous bacterial empyema, which significantly increases the risk of morbidity and mortality.
- A Case Report of Community- Acquired Empyema Resulting in Surgical Decortication with Prolonged Antibiotic Therapy: A Case Series and Review of the Literature.
Infect Disord Drug Targets
May 2024
Department of Internal Medicine, HCA Healthcare Las Palmas/Del Sol Internal Medicine Program, El Paso, Texasc, USA.
Article Synopsis
- Anaerobic bacteria can cause serious infections, including a rare form of community-acquired pneumonia, as seen in a recent case of a patient with empyema despite lacking typical risk factors for aspiration.
- A 59-year-old male, with only a long history of smoking, presented with complications stemming from left flank pain and shortness of breath, leading to imaging that revealed a complicated parapneumonic effusion requiring surgery and antibiotics.
- The case emphasizes the rising incidence of anaerobic empyema and suggests that healthcare providers should consider anaerobic coverage when treating community-acquired empyema, even in patients who don't show usual risk factors.
Invasive group A streptococcal infections in children and adolescents in Denmark during 2022-23 compared with 2016-17 to 2021-22: a nationwide, multicentre, population-based cohort study.
Lancet Child Adolesc Health
February 2024
Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Article Synopsis
- A significant rise in invasive group A streptococcal (iGAS) infections in children was observed globally in 2022, prompting a study in Denmark to compare the incidence and severity of these infections across different clinical types and GAS emm variants over multiple seasons from 2016 to 2023.
- The study was a nationwide, multicentre cohort analysis that included data from all Danish children and adolescents aged 0-17 with confirmed iGAS infections, using data from active hospital records and the Danish Microbiology Database.
- Of the 1.15 million Danish children, 174 cases of iGAS were studied, with 76 cases specifically identified in the 2022-23 period; this reflects differences
Complicated Management of Left-Sided Loculated Empyema Secondary to Streptococcus intermedius and Prevotella in a 53-Year-Old Male.
Cureus
October 2023
Internal Medicine, Conemaugh Memorial Medical Center, Johnstown, USA.
Article Synopsis
- - The case involves a 53-year-old man with a severe left-sided parapneumonic effusion that required surgical intervention.
- - Treatment included video-assisted thoracoscopic surgery and part removal of the lung tissue due to complications.
- - During his hospital stay, the patient faced multiple serious issues such as sepsis, respiratory failure, alcohol withdrawal symptoms, and a brief stroke-like episode (transient ischemic attack).
Rapid detection of S. pyogenes and S. pneumoniae in pleural fluid for diagnosis of parapneumonic empyema.
Eur J Clin Microbiol Infect Dis
January 2024
Department of Medical Microbiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
The aim of this study was to assess the reliability of rapid antigen detection tests (RADT) for Streptococcus pyogenes (GAS) and Streptococcus pneumoniae on pleural fluid samples for diagnosis of parapneumonic effusion/empyema (PPE) and their potential for improving pathogen identification rates. Sixty-three pleural samples were included from 54 patients on which GAS and S. pneumoniae RADT (BinaxNOW), culture, 16S rRNA PCR, and S.
View Article and Find Full Text PDFEffects of Concurrent Dosing on the Efficacy of Tissue Plasminogen Activator and Deoxyribonuclease in the Treatment of Pleural Infection.
Cureus
October 2023
Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Cincinnati, USA.
Background: The goal of this study was to evaluate how the administration of concurrent tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy with variable dosing for complicated parapneumonic effusions and empyema affects patient outcomes in an inner-city community hospital.
Methods: This retrospective analysis was performed at an inner-city hospital located in Raleigh, North Carolina. A list of all patients treated with tPA and DNase between July 1, 2015, and December 31, 2017, was generated and screened.
Pleural penetration of amoxicillin and metronidazole during pleural infection: An ambispective cohort study.
Int J Antimicrob Agents
December 2023
Department of Respiratory Diseases, Rennes University Hospital, Rennes, France; University of Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France.
Objectives: The pharmacokinetics of antibiotics in pleural fluid during pleural infections has been poorly described. This study aimed to explore amoxicillin and metronidazole diffusion into the pleural space.
Methods: This was an ambispective, single-centre study that included patients with complicated parapneumonic effusion or pleural empyema managed with repeated therapeutic thoracentesis as first-line treatment between 2014 and 2022.
Is chest drain insertion and fibrinolysis therapy equivalent to video-assisted thoracoscopic surgery to treat children with parapneumonic effusions?
Arch Dis Child
November 2023
Department of Paediatric Infectious Diseases, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK