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thoracic empyema

Sijan Basnet, Izza Mir, Elan Mohanty, Rashmi Dhital, Biswaraj Tharu, Dilli Ram Poudel
Empyema caused by clostridial infections is rare especially in the absence of invasive thoracic procedures. We present the case of an 81-year-old man without a history of preceding trauma who presented with shortness of breath and nonproductive cough and grew Clostridium perfringens only in the pleural cavity. He was predisposed to the infection due to his swallowing dysfunction. He was treated with penicillin and chest tube placement for drainage and subsequently improved.
2018: Case Reports in Infectious Diseases
Francesco Petrella, Lorenzo Spaggiari
Two main fields of clinical applications of stem cells in thoracic surgery have been explored: (a) regenerative medicine, that is a branch of translational research in tissue engineering and molecular biology dealing with the replacement, engineering or regeneration of cells, tissues and organs to restore normal function; (b) drug loading and delivery, that is an emerging field proposing stem cells as vectors to deliver anti-cancer agents for targeted therapies.Bronchopleural fistula is a pathological connection between the bronchus and the pleural cavity that may develop after lung resection, thus causing pleural empyema due to colonization by resident airway bacteria; stem cells and regenerative medicine approach can effectively contribute to impaired bronchial healing, thus preventive a septic and ventilator catastrophe...
March 1, 2018: Advances in Experimental Medicine and Biology
Masahiro Yanagiya, Jun Matsumoto, Masaaki Nagano, Masashi Kusakabe, Yoko Matsumoto, Ryutaro Furukawa, Sayaka Ohara, Kazuhiro Usui
RATIONALE: The development of postoperative bronchopleural fistula (BPF) remains a challenge in thoracic surgery. We herein report a case of BPF successfully treated with endoscopic bronchial occlusion under computed tomography (CT) fluoroscopy and virtual bronchoscopic navigation (VBN). PATIENT CONCERNS: A 63-year-old man underwent right upper lobectomy with concomitant S6a subsegmentectomy for lung adenocarcinoma. On postoperative day 24, he complained of shaking chills with high fever...
February 2018: Medicine (Baltimore)
Anil Gautam, Gregory G Wiseman, Marika L Goodman, Simon Ahmedpour, Daniel Lindsay, Adele Heyer, Harry Stalewski, Robert E Norton, Andrew V White
AIM: The Townsville Hospital and Health Service is the regional referral centre for children in the north of Queensland. Aboriginal and Torres Strait Islander (ATSI) people make up 7-10% of the population. Increasing numbers of children with paediatric thoracic empyema (pTE) are being referred to Townsville Hospital and Health Service for management. This study aims to describe the incidence rates, epidemiology, microbiology and trends of this disease in North Queensland over a 10-year period...
February 14, 2018: Journal of Paediatrics and Child Health
Jengyuan Wu, Chienming Liu, Shangsen Lee, Yuhung Kuo, Tengfu Hsieh
BACKGROUND: Patients with thoracic empyema have an increased risk of mortality, but their absolute rate of mortality depends on age and comorbidities. OBJECTIVE: This study seeks to assess the predictive value of the Charlson Comorbidity Index score (CCIS), CHADS2 and CHA2DS2-VASc scores for mortality risk in patients with empyema thoracis. METHODS: From Taiwan's National Health Insurance Research Database we identified a total of 484 participants diagnosed with thoracic empyema...
January 19, 2018: Heart & Lung: the Journal of Critical Care
A Noël, A Verroken, L Belkhir, H Rodriguez-Villalobos
We report the case of a 69-year-old man admitted for septic shock secondary to necrotic pneumoniae complicated by thoracic empyema of fatal issue. Microbiological examination of pleural liquid revealed a mixed anaerobic flora involving Campylobacter rectus and Actinomyces meyeri. Campylobacter rectus is an infrequent anaerobic pathogen of oral origin To our knowledge, this is the first case report of fatal C. rectus - associated thoracic empyema, and only the second reported case in which identification was successfully performed by MALDI-TOF MS...
January 8, 2018: Anaerobe
Srinivas Rajagopala, Roopa Kancherla, Ramanathan Palaniappan Ramanathan
Tuberculosis (TB) is a rare cause of chylothorax. We describe a case and the results of a systematic review of all reported cases of TB-chylothorax. We identified 37 cases of TB-chylothorax. The symptoms at presentation were constitutional (85.7%; 30/35), dyspnea (60.6%; 20/33), and cough (54.5%; 18/33). Chylothorax developed subsequent to the diagnosis of TB in 27.8% (10/36) of the patients, after a median of 6.75 weeks (IQR 4-9). Chylothorax developed during an immune reconstitution syndrome (IRS) in 16.7% (10/36) of the patients, including immunocompetent ones...
January 9, 2018: Respiration; International Review of Thoracic Diseases
A Tampakis, E C Tampaki, K Kontzoglou, E Patsouris, G Kouraklis, D Lardinois
OBJECTIVE: Infections with Corynebacterium tuberculostearicum are very rare as in most of the cases its isolation is associated with tissue colonization rather than infection. CASE REPORT: An 80-year old female patient was sent to the consultation hour of thoracic surgery for evaluation of a symptomatic persistent unilateral pleural effusion of her right lung. The differential diagnosis included either the presence of a chronic pleural empyema or the presence of malignancy...
November 2017: European Review for Medical and Pharmacological Sciences
Martin Reichert, Bernd Pösentrup, Andreas Hecker, Emmanuel Schneck, Jörn Pons-Kühnemann, Florian Augustin, Winfried Padberg, Dietmar Öfner, Johannes Bodner
BACKGROUND: Pleural empyema is an infectious disease of the chest cavity, with a high morbidity and mortality. According to the American Thoracic Society, pleural empyema gets graduated into three stages, with surgery being indicated in intermediate stage II and chronic stage III. Evidence for the feasibility of a minimally-invasive video-assisted thoracoscopic approach in stage III empyema for pulmonary decortication is still little. METHODS: Retrospective single-center analysis of patients conducted to surgery for chronic stage III pleural empyema from 05/2002 to 04/2014 either by video-assisted thoracoscopic surgery (VATS, n = 110) or conventional open surgery by thoracotomy (n = 107)...
December 7, 2017: Surgical Endoscopy
Tanja Walgram, Nicolas Attigah, Igor Schwegler, Markus Weber, Omer Dzemali, Christian Berthold, Dirk Wagnetz, Giovanni L Carboni
OBJECTIVES: Tumour infiltration, or gross infectious involvement of the thoracic aortic wall, poses a significant intraoperative risk for fatal bleeding and therefore could compromise adequate resection or efficient surgical management of pleural infection in a considerable amount of cases. We present 3 successful cases of off-label thoracic aortic endografting to safeguard thoracic aortic wall integrity. METHODS: After all patients received thoracic stent grafts through femoral access into the descending aorta, the first patient underwent a resection of a locally advanced squamous cell carcinoma of the left inferior lobe cT4cN0-1cM0 after neoadjuvant chemoradiation, which had infiltrated the descending aortic wall...
November 22, 2017: Interactive Cardiovascular and Thoracic Surgery
Marharyta Kamarova, Richard Kendall
BACKGROUND: There is a lack of clarity regarding the use of prophylactic antibiotics for patients presenting with penetrating injuries. A structured literature review and review of penetrating injury records in an MTC was undertaken with a view to help guide clinical practice. METHOD: Searches were conducted on Medline (1946-2017), Embase (1974-2017), and Cochrane (up to 2017) using key words pertaining to penetrating trauma, prophylactic antibiotics and infection...
December 2017: Emergency Medicine Journal: EMJ
Brian Whang
Thoracic surgeons are sometimes asked to consult on the management of a patient who is pregnant. Conditions commonly encountered are empyema, spontaneous pneumothorax, and diaphragmatic hernia. Lung cancer is rarely seen in pregnancy, but its incidence is rising. Diagnostic imaging and perioperative management involve the navigation of fetal risks and nuances in maternal physiology. Shared decision making within a multidisciplinary framework will optimally guide the course of management.
February 2018: Thoracic Surgery Clinics
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
Hongsun Kim, Younghwan Kim, Jong Ho Cho, Yang Won Min
A 71-year-old man presented with a productive cough and fever, and he was diagnosed as having an esophageal perforation and a mediastinal abscess. He had a history of traumatic hemothorax and pleural drainage for empyema in the right chest and was considered unable to tolerate thoracic surgery because of sepsis and progressive aspiration pneumonia. In order to aggressively drain the mediastinal contamination, we performed internal drainage by placing a Levin tube into the mediastinum through the perforation site...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
Qiuyuan Li, Alan Sihoe, Haifeng Wang, Diego Gonzalez-Rivas, Yuming Zhu, Dong Xie, Gening Jiang
OBJECTIVES: Although there is growing interest in single-port video-assisted thoracic surgery for a number of thoracic operations, there is still not enough known about its use for mediastinal pathologies. The present study was aimed at assessing the safety and efficacy of single-port video-assisted thoracic surgery in comparison with the multi-port variants in terms of short-term perioperative outcomes. METHODS: From July 2013 to December 2015, 285 consecutive non-myasthenic adult patients undergoing single- or multi-port video-assisted thoracic surgery for mediastinal diseases including thymoma were retrospectively reviewed...
January 1, 2018: European Journal of Cardio-thoracic Surgery
Stefano Sanna, Luca Bertolaccini, Jury Brandolini, Desideria Argnani, Marta Mengozzi, Alessandro Pardolesi, Piergiorgio Solli
The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay...
2017: Journal of Visualized Surgery
Periklis Perikleous, Sridhar Rathinam, David A Waller
A negative pressure normally exists between the visceral and parietal pleurae in the lungs, which can act as vacuum for fluid, air and small particles from different parts of the body, allowing them to move into the pleural space and be retained in it, thus resulting to different manifestations of pleural disorders. A pleural effusion is the result of fluid collection between the parietal and visceral pleural surfaces. The most common cause in developed countries is congestive heart failure, followed by pneumonia and malignancy...
2017: Journal of Visualized Surgery
Mohsen Sokouti, Morteza Ghojazadeh, Massoud Sokouti, Babak Sokouti
BACKGROUND: There are several studies reporting high success rates for surgical and nonsurgical treatments of empyema separately. The aim of current retrospective cohort study is to find the best treatment in low socio-economic areas. MATERIAL AND METHODS: A total of 149 patients were treated in the referring hospital from January 2002 to December 2008. The current retrospective cohort study was carried out by nonsurgical (medically & thoracenthesis & chest tube drainage with or without fibrinolytic agents) and surgical (VATS &open thoracotomy decortication methods) procedures in single center performed in thoracic and respiratory medicine wards...
December 2017: Annals of Medicine and Surgery
Kingsfield Ong, Keerthi Rajapaksha, Chin Siang Ong, Ali Akbar Fazuludeen, Aneez Dokeu Basheer Ahmed
BACKGROUND: There is a continuous debate on the appropriate diagnostic approach and surgical management of mycobacterial empyema, with widely varied diagnostic practices and surgical outcomes. The aim of this study is to highlight the diagnostic approach and clinical features of patients who required surgical intervention for mycobacterial empyema. METHODS: We performed a 5-year retrospective cohort study of all patients with mycobacterial empyema requiring surgery in a single institution from November 2009 to November 2014...
2017: Tuberculosis Research and Treatment
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago, I began using local anesthesia and sedation for pleural disease and subsequently, for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS using local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA), from June 1, 2002 to June 30, 2011, and the Lifebridge Health System (Baltimore, MD) from July 1, 2011 to March 1, 2017, were retrospectively reviewed...
January 2018: Journal of the American College of Surgeons
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