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Methods of treatment of childhood empyema in a Turkish university hospital
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Staphylococcus aureus was the most common cause of empyema in 120 patients over ten years. Most patients recovered after various surgical interventions, with low mortality.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Thoracic Surgery
Background:
- Empyema, a serious pleural infection, requires understanding its causes and effective treatments.
- Pleural effusion management is critical in clinical practice.
Purpose of the Study:
- To investigate the etiological agents and treatment outcomes for empyema.
- To analyze the clinical course and surgical interventions in empyema patients.
Main Methods:
- Retrospective analysis of 120 empyema patients admitted over ten years.
- Microbiologic analysis of pleural fluid aspirates.
- Review of surgical interventions including pleural aspiration, decortication, pulmonary resection, and drainage.
Main Results:
- Staphylococcus aureus was the predominant pathogen (36.7%), followed by streptococci (19.2%) and Pneumococcus (15%).
- 15.8% of cultures were sterile; Pseudomonas and Enterobacteria were found in 13.3%.
- Drainage and thoracic lavage were the most common interventions (52.5%), with low mortality (2.5%) from respiratory failure and septic shock.
Conclusions:
- Staphylococcus aureus is a leading cause of empyema, necessitating targeted antimicrobial therapy.
- Diverse surgical approaches are effective for empyema management, with drainage and lavage being most frequent.
- Prompt and appropriate intervention leads to favorable outcomes in the majority of empyema patients.
Abstract:
In the last ten years, 120 patients were admitted to our clinic with empyema. Empyema and effusion have been investigated for pathogenesis. Microbiologic studies of pleural aspiration fluid showed that Staphylococcus aureus was the most common pathogen, found in 44 patients (36.7 percent). Other pathogens found were streptococci in 23 (19.2 percent) and Pneumococcus in 18 (15 percent) in sequence. No production occurred in cultures of 19 (15.8 percent) patients. In 16 (13.3 percent), Pseudomonas and Enterobacteria such as E coli, Klebsiella and Proteus occurred. Surgical intervention has been carried out depending on clinical conditions. In the 24 (20 percent) patients, pleural aspiration and lavage, decortication in 23 (19.2 percent), pulmonary resection (segmentectomy, lobectomy) in seven (5.8 percent), and only drainage and thoracic lavage in 66 (52.5 percent) have been carried out. Three patients (2.5 percent) died due to respiratory failure and septic shock, and the others have been discharged with healing.