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pleural empyema

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https://www.readbyqxmd.com/read/28646887/intrapleural-dornase-and-tissue-plasminogen-activator-in-pediatric-empyema-dtpa-a-study-protocol-for-a-randomized-controlled-trial
#1
Michael H Livingston, Sanjay Mahant, Felix Ratjen, Bairbre L Connolly, Kevin Thorpe, Muhammad Mamdani, Ian Maclusky, Sophie Laberge, Lucy Giglia, J Mark Walton, Connie L Yang, Ashley Roberts, Anna C Shawyer, Mary Brindle, Simon J Parsons, Cristina A Stoian, Eyal Cohen
BACKGROUND: A randomized controlled trial of adults with empyema recently demonstrated decreased length of stay in hospital in patients treated with intrapleurally administered dornase alfa and fibrinolytics compared to fibrinolytics alone. Whether this treatment strategy is safe and effective in children remains unknown. METHODS/DESIGN: This study protocol is for a superiority, placebo-controlled, parallel-design, multicenter randomized controlled trial. The participants are previously well children admitted to a children's hospital with a diagnosis of empyema requiring chest tube insertion and fibrinolytics administered intrapleurally...
June 24, 2017: Trials
https://www.readbyqxmd.com/read/28638619/propionibacterium-acnes-pleural-empyema-following-medical-thoracoscopy
#2
Hannah Lawrence, Thomas Moore, Karmel Webb, Wei Shen Lim
Propionibacterium acnes (P. acnes) is a Gram-positive anaerobic rod and a common skin commensal that colonizes sebaceous glands. It has infrequently been associated with invasive opportunistic infections and can cause implant-associated infections through a biofilm mode of growth. Medical thoracoscopy is a common procedure for diagnosis and treatment of exudative pleural effusions; empyema is a recognized complication. We present a rare case of P. acnes pleural empyema 3 weeks following medical thoracoscopy and subsequent intercostal drain insertion for 3 days in a 75-year-old man...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28626910/intravenous-and-intracavitary-use-of-contrast-enhanced-ultrasound-in-the-evaluation-and-management-of-complicated-pediatric-pneumonia
#3
Annamaria Deganello, Vasileios Rafailidis, Maria E Sellars, Aikaterini Ntoulia, Kleanthi Kalogerakou, Gary Ruiz, David O Cosgrove, Paul S Sidhu
Pediatric pneumonia can be complicated by necrotizing pneumonia or a parapneumonic effusion either in the form of an empyema or a clear effusion. Ultrasonography (US) and computed tomography represent well-established modalities for evaluation of complicated pediatric pneumonia. Contrast-enhanced ultrasound (CEUS) was recently introduced and is gaining increasing acceptance in pediatric imaging. In this case series, we present our initial experience with both intravenous and intracavitary use of CEUS in children with complicated pneumonia...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28616283/the-use-of-thrombolytics-in-the-management-of-complex-pleural-fluid-collections
#4
Jessica Heimes, Hannah Copeland, Aditya Lulla, Marjulin Duldulao, Khaled Bahjri, Salman Zaheer, Jason M Wallen
BACKGROUND: To determine the efficacy of thrombolytics for the management of complex pleural fluid collections. METHODS: We reviewed patients that received alteplase for persistent loculated pleural fluid collections after simple tube drainage between July 01, 2007 and November 01, 2012. Our alteplase protocol is 6 mg of alteplase in 50 mL of normal saline injected into the pleural chest tube. The chest tube is clamped for four hours and then opened. Normally this is repeated daily for 2 to 3 days (d)...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28593157/early-aggressive-surgical-treatment-of-multiloculated-empyema
#5
Jong Hyun Baek, Young Uk Lee, Seok Soo Lee, Jang Hoon Lee, Jung Cheul Lee, Myeong Su Kim
BACKGROUND: Empyema is the collection of purulent exudate within the pleural space. Overall, 36%-65% of patients with empyema cannot be treated by medical therapy alone and require surgery. Multiloculated empyema is particularly difficult to treat with percutaneous drainage. Therefore, we describe our experiences with early aggressive surgical treatment for rapid progressive multiloculated empyema. METHODS: From January 2001 to October 2015, we retrospectively reviewed 149 patients diagnosed with empyema who received surgery...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28579346/combined-spontaneous-bacterial-empyema-and-peritonitis-in-cirrhotic-patients-with-ascites-and-hepatic-hydrothorax
#6
Anwar Mohamed, Mohammed Atef, Ayman Alsebaey, Mahmoud Musa Elhabshy, Mohsen Salama
BACKGROUND AND STUDY AIMS: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM. PATIENTS AND METHODS: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm(3)) and SBEM (positive pleural fluid culture and neutrophils >250/mm(3) or negative pleural fluid culture and neutrophils >500/mm(3) with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT)...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28545901/management-of-aspergillus-pleural-empyema-with-combined-systemic-and-intrapleural-antifungal-therapy-in-a-pediatric-patient-case-report
#7
Alanoud Almuhareb, Zakaria Habib
We present the case of an 8-year-old immunocompromised boy with invasive pulmonary aspergillosis, complicated with pleural empyema and disseminated to the bone and central nervous system (CNS). The patient was treated with combined systemic antifungal agents (voriconazole and caspofungin) and intrapleural instillation of liposomal amphotericin B, in addition to surgical intervention. The treatment was well tolerated and resulted in remarkable clinical and radiological pulmonary improvement.
May 22, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28507831/streptococcus%C3%A2-gordonii%C3%A2-empyema-a-case-report-and-review-of-empyema
#8
Amanda M Krantz, Felicia Ratnaraj, Manasa Velagapudi, Mridula Krishnan, Nagarjuna R Gujjula, Pamela A Foral, Laurel Preheim
Streptococcus gordonii (S. gordonii) is a pioneer oral bacteria that is recognized as an agent of bacterial endocarditis. However, an extensive review of the literature revealed no reported case of S. gordonii causing empyema. We present a case of a 65-year-old male who presented with respiratory distress. Physical examination revealed several dental caries with decreased breath sounds in the bibasilar regions. A computed tomography (CT) scan of the chest and abdomen demonstrated left-sided pleural effusion and a 4...
April 12, 2017: Curēus
https://www.readbyqxmd.com/read/28479076/persistent-benign-pleural-effusion
#9
J M Porcel
In this narrative review we describe the main aetiologies, clinical characteristics and treatment for patients with benign pleural effusion that characteristically persists over time: chylothorax and cholesterol effusions, nonexpansible lung, rheumatoid pleural effusion, tuberculous empyema, benign asbestos pleural effusion and yellow nail syndrome.
May 4, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28474458/accuracy-of-complement-activation-product-levels-to-detect-infected-pleural-effusion-in-rats
#10
Guilherme E Peterson, Samanta S Silva, Sérgio L Amantéa, Patrícia Miorelli, Paulo Sanches, Jane Kulczynski, Eliane Roesch, José Carlos Fraga
BACKGROUND: Pleural empyema is a well-known complication of pneumonia. If treatment is delayed, empyema may increase morbidity and mortality in affected patients. Therefore, the identification of empyema biomarkers in parapneumonic pleural effusion is desirable. Previous research has suggested complement activation products as candidate empyema markers. OBJECTIVE: To compare the levels of complement activation products C3a, C5a, and C5b9 in pleural effusion induced by Staphylococcus aureus (SA), Streptococcus pneumoniae (SP), or turpentine (control)...
June 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28474099/a-three-step-diagnosis-of-pediatric-pneumonia-at-the-emergency-department-using-clinical-predictors-c-reactive-protein-and-pneumococcal-pcr
#11
Gabriel Alcoba, Kristina Keitel, Veronica Maspoli, Laurence Lacroix, Sergio Manzano, Mario Gehri, René Tabin, Alain Gervaix, Annick Galetto-Lacour
Recommendations for the management of community-acquired pneumonia (CAP) advocate that, in the absence of the clinical and laboratory findings typical of bacterial CAP, antibiotics are not required. However, the true value of the clinical and laboratory predictors of pediatric CAP still needs to be assessed. This prospective cohort study in three emergency departments enrolled 142 children with radiological pneumonia. Pneumonia with lung consolidation was the primary endpoint; complicated pneumonia (bacteremia, empyema, or pleural effusion) was the secondary endpoint...
May 4, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#12
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28458144/gastropleural-fistula-after-single-anastomosis-gastric-bypass-a-case-report-and-review-of-the-literature
#13
Haider Al-Shurafa, Saleh Alghamdi, Ali Albenmousa, Haifa Alolayan, Zahraa Al-Shurafa
INTRODUCTION: Pulmonary complications after bariatric surgeries are rare but usually serious. They often occur early after surgery but the presentation might be delayed for several months. Gastropleural fistula after bariatric surgery is extremely rare and has been reported in a very small number of patients post sleeve gastrectomy and gastric bypass. CASE PRESENTATION: A 37-year-old lady presented with left sided pleural effusion and empyema 2 years post single anastomosis gastric bypass surgery...
April 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28450195/evaluation-of-the-eazyplex-mrsa-assay-for-the-rapid-detection-of-staphylococcus-aureus-in-pleural-and-synovial-fluid
#14
D Henares, P Brotons, X Buyse, I Latorre, H D de Paz, C Muñoz-Almagro
OBJECTIVE: Loop-mediated isothermal amplification (LAMP) is a simple and sensitive technique for rapid microbiological diagnosis. The aim of this study was to evaluate the analytical and diagnostic performance of the LAMP eazyplex MRSA test for the direct detection and differentiation of methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in synovial/pleural fluid. METHODS: Analytical validation included the determination of the limit of detection (LoD) and analytical specificity of the eazyplex MRSA test...
April 24, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28449653/a-case-report-of-parapneumonic-pleural-effusion-caused-by-streptococcus-pneumoniae-serotype-19a-in-a-child-immunized-with-13-valent-conjugate-pneumococcal-vaccine
#15
Idrissa Diawara, Khalid Zerouali, Naima Elmdaghri, Abderrahman Abid
BACKGROUND: Simple parapneumonic effusion is a pleural effusion associated with lung infection (i.e., pneumonia). Streptococcus pneumoniae remains the most common pathogen causing parapneumonic effusions. In Morocco, the pneumococcal conjugate vaccine 13-valent (PCV13) was introduced in the national immunization program in October 2010 in 2 + 1 schedule for prevention of pneumococcal disease, and replaced by the PCV10 in July 2012 in the same schedule. We report a case of parapneumonic pleural effusions caused by S...
April 27, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28449484/clinical-presentation-and-characteristics-of-25-adult-cases-of-pulmonary-sequestration
#16
Mateusz Polaczek, Inga Baranska, Malgorzata Szolkowska, Jacek Zych, Piotr Rudzinski, Janusz Szopinski, Tadeusz Orlowski, Kazimierz Roszkowski-Sliz
BACKGROUND: Pulmonary sequestration (PS) is a rare congenital abnormality of lung tissue. Only few series of adult cases are reported. The aim was to describe clinical characteristics in adult cases of PS and to compare outcomes in different clinical situations. METHODS: Using MSD engine we searched for cases of PS that have been diagnosed between Jan 1st, 2005 and Dec 31st, 2015. Clinical data was retrospectively gathered. Statistica v.12 (StatSoft, Inc.) was used for statistical analyses...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28436267/pneumonia-with-pleural-empyema-caused-by-salmonella-typhi-in-an-immunocompetent-child-living-in-a-non-endemic-country
#17
Gwénaëlle Duhil de Bénazé, Emilie Desselas, Véronique Houdouin, Patricia Mariani-Kurkdjian, Ahmed Kheniche, Stéphane Dauger, Géraldine Poncelet, Jean Gaschignard, Michaël Levy
Extra-intestinal complications of Salmonella Typhi (S. Typhi) infections usually occur in endemic countries and in patients with underlying risk conditions. A 14-year-old immunocompetent girl was admitted with respiratory distress owing to S. Typhi pneumonia and pleural empyema. She was a native of Ivory Coast but had lived in France for 4 years and had not travelled abroad for several years. There were no gastro-intestinal symptoms and no S. Typhi carriage was detected in her family. She recovered completely with ceftriaxone and ciprofloxacin and pleural drainage was not required...
April 24, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28418364/-evolution-of-complex-treatment-of-patients-with-non-specific-pleural-empyema
#18
O O Yasnogorodsky, A M Shulutko, T P Pinchuk, E G Gandybina, A S Kachikin, F N Nasirov, A Yu Moiseev, S E Gryaznov
AIM: To analyze long-term own experience of NPE treatment in view of evolution of surgical sanitation of pleural cavity. MATERIAL AND METHODS: The analysis included 5115 patients with NPE for the last 39 years (1977-2015). Morbidity, features of microflora of purulent exudate, changes in the structure of surgical methods were assessed. The role of computed tomography in the diagnostic algorithm and treatment of NPE was studied. RESULTS: The evolution of NPE surgical management includes introduction of video technologies, thermal surgical instruments and widespread use of computed tomography in the diagnosis of pleural empyema...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#19
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28414681/what-can-erode-through-lungs-bone-and-skin
#20
J M Manalac, D Shankaranayanan, J Paul-Olivier, L Guidry, N R Sells
CASE: A 51 year old African American Man without significant past history presented with three weeks of persistent cough productive of copious yellow sputum. He denied fevers, chills, hemoptysis, dyspnea, weight or appetite changes, sick contacts, recent travel. On physical examination, the patient was afebrile and appeared comfortable. He had decreased air entry of the left lower lobe with dullness to percussion. A 5x3 cm fluctuant mass was incidentally found on the left anterior chest wall at the level of the 11th rib with yellow expressible exudate at which time the patient reported a minor trauma sustained 3 weeks prior...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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