NON-TUBERCULAR EMPYEMA THORACIS- A COMPARATIVE ANALYSIS OF GRAM POSITIVE AND GRAM NEGATIVE ORGANISM ASSOCIATED EMPYEMA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 61
Abstract
BACKGROUND Empyema thoracis is an entity resulting in significant morbidity and mortality. Bacterial empyema is the commonest cause of empyema globally. Clinical course and outcome of empyema varies in patients. This study was carried out to evaluate clinical profile, diagnosis and outcome parameters of non-tubercular empyema cases with special interest to find out the differences between Gram positive and Gram negative organism associated empyemas in terms of clinical presentation and outcome issues. MATERIALS AND METHODS A prospective observational study of all cases of bacterial empyema thoracis admitted in the Department of Respiratory Medicine in a teaching institution over a period of 18 months was conducted. Out of the total no. of cases where pleural fluid culture was positive, a comparative analysis was done between cases of empyemas caused by Gram positive organisms and Gram negative organisms in terms of clinical characteristics, treatment and outcome issues. RESULTS A total no. of 95 empyema cases were encountered during the study period, of which fifty five were bacterial empyema. Pleural fluid culture was positive in 54.55% cases. Staphylococcus aureus (15, 27.3%) was the most frequent pathogen isolated. On comparative analysis of empyema cases caused by Gram positive and Gram negative organisms, it was found that Gram negative organism related empyemas was more frequent in older population and in people with co-morbidities. Clinical course of illness was more protracted and mean duration of intercostal tube drainage were longer (39.5 vs 17 days) in patients with Gram negative organism related empyemas. Presence of bronchopleural fistula was more in Gram negative empyemas and the need for surgical intervention was also higher in this group. CONCLUSION Bacterial empyema thoracis is the commonest cause of empyema. Gram negative organism related empyemas significantly differs from Gram positive organism related empyemas in terms of their clinical profile, increased occurrence of bronchopleural fistula and management issues.
Authors and Affiliations
Subhasis Mukherjee, Shabana Begum, Subhra Mitra, Somenath Kundu
Keywords
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- EP ID EP227063
- DOI 10.14260/Jemds/2017/961
- Views 89
- Downloads 0
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