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Updated: Jun 20, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

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Published on: November 10, 2023

Empyema thoracis: a clinical study.

Preetam Rajgopal Acharya¹, Kusum V Shah

¹Dept. of TB and Chest Diseases, Kasturba Medical College, Attavar, Mangalore, Karnataka, India. dokpreet@yahoo.co.in

Annals of Thoracic Medicine

|September 3, 2009

Summary

Empyema thoracis, a serious condition, is most common in young to middle-aged males. Management varies from aspiration for simple cases to chest tube drainage or surgery for complex empyema.

Area of Science:

Pulmonology
Thoracic Surgery
Infectious Diseases

Background:

Empyema thoracis remains a significant cause of morbidity and mortality despite extensive study.
Understanding its epidemiology and management is crucial for improving patient outcomes.

Purpose of the Study:

To investigate the age-sex distribution, clinical presentation, microbiological characteristics, causes, and treatment outcomes of empyema thoracis.
To analyze patient data from a tertiary care hospital setting.

Main Methods:

A prospective study involving 40 consecutive patients with empyema thoracis.
Data collection included demographics, clinical symptoms, microbiology, etiology, and treatment course.
Analysis of recorded data using a planned pro forma.

Keywords:

Closed tube thoracostomy empyema parapneumonic effusion

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Main Results:

The peak incidence of empyema thoracis was observed in individuals aged 21-40 years, with a male predominance (3.4:1.0).
Common risk factors included tuberculosis, COPD, smoking, diabetes, and pneumonia. Tuberculosis was the etiology in 65% of cases.
Intercostal chest tube drainage was the primary treatment (95%), with an average drainage duration of 22.3 days for complete expansion cases.

Conclusions:

Simple empyema with thin pus or small-volume thick pus can be managed with aspiration.
Intercostal drainage is recommended for larger or more complex empyema cases, including those with bronchopleural fistula.
Empyema with bronchopleural fistula presents management challenges and often requires major surgery.