[Thoracic empyema caused by anaerobes. 78-month retrospective study. Clinical and microbiological aspects]

The authors considered the microbiological and clinical aspects of the thoracic empyemas caused by anaerobic bacteria observed at the Ivrea-Castellamonte Hospital, Turin, over a period of 78 months. In this period 321 patients were subjected to thoracentesis in order to take samples of the pleural fluid (PF) which was in turn subjected to culture investigations. 31 patients (9.6%) had one or more cultures which were positive for bacterial growth. A good 12 patients (38.7%) had cultures which were positive for anaerobes alone or associated with aerobes. The average age of these patients (8 male, 4 female) was 62.5 years (range, 42 TO 84 Y.). Underlying diseases and predisposing conditions were as follows: malignancy (4 patients), neurological disorders (4p), severe hypoalbuminemia (5 p), bronchial obstruction (3 p), previous gastroenteric or chest surgery (3 p), diabetes mellitus (2 p), alcoholism (2 p), atherosclerosis (1 p), alveolar hypoventilation caused by chest wall disorder (1 p). The etiopathogenesis of the empyema was as follows; postpneumonic, 5 cases (41.7%); postsurgical, 4 cases (33.3%); esophageal fistula, 1 case (8.3%); idiopathic, 2 cases (16.7%). In 5 cases (441.7%) empyema developed in hospital, in 7 cases (58.3%) in community. Forty-one percent of the empyemas were described as foul-smelling. The anaerobic bacteria most frequently isolated were Bacteroides spp, Fusobacterium nucleatum, Peptostreptococci in this order. Thoracentesis was performed on 6 patients, chest tube drainage was required in 6, and antibiotics were administered to all the patients. Length of Hospitalization averaged 33>2 days. Three patients (30%) died. These patients died during the same hospitalization period while empyema was an active problem.(ABSTRACT TRUNCATED AT 250 WORDS)