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.