TO DETERMINE THE FACTORS PROMOTING FAVOURABLE TREATMENT OUTCOME OF EMPYEMA THORACIS AND COMPLICATED PARAPNEUMONIC EFFUSION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 4
Abstract
BACKGROUND The annual incidence of bacterial pneumonia is quite high with 40% of hospitalised patients have accompanying pleural effusion. The morbidity and mortality rates in patients with pneumonia and pleural effusions are higher than those in patients with pneumonia alone. Early drainage of pus from the pleural cavity along with broad-spectrum antibiotics still remains the cornerstone of treatment. Very few earlier studies have focused on the predicting factors for favourable outcome of parapneumonic effusion and empyema. MATERIALS AND METHODS Study Design- A prospective study. A total of 61 patients with diagnosis of complicated parapneumonic effusion and empyema were enrolled. Patient’s characteristics, comorbidities, duration of symptoms, pleural fluid characteristics and radiological features were noted. All cases were treated with either large bore or small bore chest tubes to drain pleural fluid. Intrapleural Streptokinase was instilled in non-responding patients. Their relation to treatment outcome was evaluated using non-parametric Mann-Whitney U test, Chi-square technique and Fisher’s exact test. RESULTS No significant relation exists between presence of comorbidity and outcome; though diabetic patients, smokers and alcoholics had comparatively poorer outcome. All bore pigtail catheters are effective in management of complicated parapneumonic effusion and loculated empyema. Intrapleural streptokinase increases drainage and improves clinical and radiological outcome. Duration of presenting symptom correlates with outcome of tube thoracostomy. CONCLUSION All cases of empyema complicated by bronchopleural fistula are difficult to manage and need surgery.
Authors and Affiliations
Seema K, Vijay Nair
Keywords
Related Articles
- EP ID EP285813
- DOI 10.14260/jemds/2018/95
- Views 90
- Downloads 0
EFFECTIVENESS OF INTERACTIVE LECTURES AS TEACHING METHODOLOGY IN OBG AMONG FINAL YEAR MEDICAL STUDENTS
BACKGROUND In conventional lectures, students are passive receivers of information and are not involved in the process of learning. To improve the classic lecture, interaction among the participants is a must. We wanted...
DISSEMINATED CYSTICERCOSIS
Cysticercosis is a systemic illness caused by dissemination of the larval form of the pork tapeworm, Taenia solium. Cysticerci may be found in almost any tissue. The most frequently reported locations are skin, skele...
OCULAR BIOMETRY IN PRIMARY ANGLE CLOSURE GLAUCOMA
OBJECTIVE To compare the ocular biometric values. Anterior chamber depth, axial length of normal subjects and primary angle closure glaucoma subjects. MATERIALS AND METHODS A prospective case control study of...
A CASE REPORT OF PRIMARY LUMBAR HERNIA- SELDOM SEEN BY SURGEONS
CASE PRESENTATION A 54-year-old moderately built gentleman presented to surgery OPD with complaints of swelling over the left lumbar region for the past 5 months associated with dull aching left sided abdominal pain for...
HISTOPATHOLOGICAL STUDY OF SALIVARY GLAND TUMOURS WITH SPECIAL EMPHASIS ON CASES WITH DIAGNOSTIC DILEMMA
BACKGROUND Tumours of salivary glands constitute less than 5% of head and neck tumours and are diverse in nature. Some of the tumours pose diagnostic challenge to a pathologist, especially the malignant lesions with poor...