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Adult empyema in Zaria, Nigeria
1Department of Surgery, Princess Royal Hospital, Telford, England.
Abstract:
The clinical records of 41 adult patients who were treated for empyema thoracis at the ABU Hospital, Zaria from 1974 to 1986 have been reviewed. Twenty six (63%) of the patients were younger than 34 years. Bacterial pneumonia, pulmonary tuberculosis and chronic bronchitis were the underlying illnesses in 32 (78%) while advanced malignancies were present in two others. Gram-negative bacilli were as important as the gram-positive cocci as causative agents in the 16 patients whose pleural aspirates were culture-positive. Closed chest tube drainage was most often effective when combined with antibiotics. Overall, 5 patients died, 2 absconded, 34 were discharged home but the default rate from the follow up clinic was high.
Insights
This study on empyema thoracis found that Gram-negative bacilli and Gram-positive cocci are key causes. Treatment combining chest tube drainage and antibiotics proved most effective for patients with this serious pleural infection.
Area of Science:
- Medicine
- Pulmonology
- Infectious Diseases
Background:
- Empyema thoracis is a serious pleural space infection.
- Understanding causative agents and effective treatments is crucial for patient outcomes.
Purpose of the Study:
- To review clinical records of adult patients treated for empyema thoracis.
- To identify underlying illnesses, causative agents, and treatment efficacy.
Main Methods:
- Retrospective review of 41 adult patient clinical records.
- Analysis of patient demographics, underlying conditions, causative pathogens, and treatment outcomes.
Main Results:
- The majority of patients (63%) were under 34 years old.
- Common underlying illnesses included bacterial pneumonia, tuberculosis, and chronic bronchitis (78%).
- Both Gram-negative bacilli and Gram-positive cocci were significant causative agents in culture-positive cases.
- Closed chest tube drainage combined with antibiotics showed the highest effectiveness.
Conclusions:
- Empyema thoracis affects a significant proportion of younger adults.
- A combination of chest tube drainage and antibiotics is recommended for effective management.
- High default rates from follow-up clinics pose a challenge to long-term patient care.