[Nontuberculous purulent pleural effusion in adults in Yaounde, Cameroon]

The aim of this study is to analyze current etiologic, bacteriologic and prognostic features of nontuberculous purulent pleural effusion in adults in Yaounde, Cameroon.

This study prospectively included 54 adults hospitalized for community-acquired nontuberculous purulent pleural effusion in the chest-disease clinic of the Jamot Hospital in Yaounde from August 2007 to July 2010.

The study included 34 men and 20 women with a mean age of 40.8 ± 16.4 years. At least one or more predisposing condition or underlying disease was found in 59.2%. The most frequent predisposing condition was HIV infection, seen in 35.2% of patients. In 92.6% of patients (n=50), purulent pleural effusion followed acute bronchopulmonary infection. Positive cultures of pleural fluid were found in half the patients. Streptococcus pneumoniae was the most common bacteria identified (41.4%) followed by Staphylococcus aureus (20.7%). Anaerobic bacteria were isolated in only 13.4% (n=4). Improvement was achieved in 79.6% of patients (n=43) and the in-hospital mortality rate was 3.7%. The mean duration of hospitalization was 26.8±15.6 days.

This study indicates that HIV infection is the most frequent predisposing condition for community-acquired nontuberculous purulent pleural effusion in adults in Yaounde. The most commonly isolated bacterial pathogen was S. pneumoniae. Although the mortality rate of this disease is low, its prevention by proper management of acute respiratory tract infection is important.