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empyema management

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https://www.readbyqxmd.com/read/28802374/secondary-encephalocele-in-infant-following-subdural-empyema-repaired-endoscopically-a-case-report
#1
Roshan K Verma, Navjot Kaur
Subdural empyema (SDE) is an uncommon entity, mostly associated with meningitis and can be life threatening in infants. Rarely, a subdural empyema can lead to nasal encephalocele which can be challenging situation to manage especially in infant. We present a case of 7 month old infant who presented with subdural empyema that led to formation of nasal encaphalocele after 4 months which was managed endoscopic route.
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28790284/-management-of-postoperative-wound-infection-and-empyema
#2
Hirofumi Uehara, Masafumi Kawamura
Postoperative wound infection and empyema after pulmonary surgery is considered surgical site infection. Postoperative empyema (PE) is a rare but potentially fatal complication of pulmonary resections and proper management is essential. Appropriate antibiotics and surgical treatment is necessary to cure the PE. PE is often associated with bronchopleural fistula, which makes the management of PE difficult. The treatment of empyema has the basic way of thinking, but there are various cures, closed tube thoracostomy, video-assisted thoracoscopy, emergency open window thoracostomy, and Endoscopic conservative treatment may necessary...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28781127/evolution-of-practice-in-the-management-of-parapneumonic-effusion-and-empyema-in-children
#3
D Griffith, M Boal, T Rogers
AIM: To assess the evolution in management of children with parapneumonic effusion and empyema in a tertiary referral centre. METHOD: We conducted a retrospective case note review of paediatric patients with parapneumonic effusion, pleural effusion and pleural empyema between December 2006 and December 2015. Digital database searches were performed to identify demographic data, referring hospital, radiological and microbiological investigations. Length of stay and morbidity were analysed...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28741193/burr-hole-craniostomy-for-chronic-subdural-hematomas-by-general-surgeons-in-rural-kenya
#4
John K Kanyi, Timothy V Ogada, Mark J Oloo, Robert K Parker
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub-Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement. METHODS: We conducted a retrospective chart review of all patients with cSDH who underwent burr-hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28705799/rapid-developing-empyema-by-group-f-beta-streptococcus-anginosus-group
#5
Muhammad Azharuddin, Dy Prudence, Prem Shanker Shukla, Ajay Mathur
A 43-year-old male had progressive pleuritic left-sided chest tightness with shortness of breath. He had dental caries and tenderness on palpation of the left lateral chest. Complete blood count showed leucocytosis. CT scan of the chest with pulmonary emboli protocol showed multiple pulmonary nodules and nodular pleural thickening at left posterior lateral pleura. Forty-eight hours post CTPE scan, CT scan of the chest, abdomen and pelvis displayed right lower lobe consolidation and left-sided pleural effusion with superimposed compressive atelectasis...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28673640/small-tube-thoracostomy-20-22-fr-in-emergent-management-of-chest-trauma
#6
Shinsuke Tanizaki, Shigenobu Maeda, Makoto Sera, Hideya Nagai, Minoru Hayashi, Hiroyuki Azuma, Ken-Ichi Kano, Hiroki Watanabe, Hiroshi Ishida
BACKGROUND: The optimal tube size for an emergent thoracostomy for traumatic pneumothorax or hemothorax is unknown. Both small catheter tube thoracostomy and large-bore chest tube thoracostomy have been shown to work for the nonemergent management of patients with traumatic pneumothorax or hemothorax. This study was conducted to compare the efficacy of a small chest tube with that of a large tube in emergent thoracostomy due to chest trauma. Our hypothesis was that there would be no difference in clinical outcomes including tube-related complications, the need for additional tube placement, and thoracotomy, with the replacement of large tubes with small tubes...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28673074/pediatric-pleural-empyema-one-of-the-management-challenges-in-children-of-democratic-republic-of-congo
#7
Kibwe Alphonse Simbi, Valentin Kazadi, Louis-Marie Aissi, François Mbahewaka Katsuva, Numbi Oscar Luboya, Léon Tshilolo, Vincenzo Zanardo
Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo...
June 23, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/28637119/disco-vertebral-osteomyelitis-causing-intradural-spinal-abscess-with-cauda-equina-compression
#8
Anan Shtaya, Samantha Hettige
Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management.
March 3, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633248/endobronchial-guided-vascularized-tissue-flaps-for-a-bronchopleural-fistula
#9
Sarah M Elswick, Basel Sharaf, Ziyad S Hammoudeh, Ali I Saeed, Eric S Edell, David E Midthun, Shanda H Blackmon
The management of bronchopleural fistulas can be challenging. The initial treatment is usually conservative, but operative intervention with transposition of vascularized pedicled flaps may be required in refractory cases. We present the case of a 67-year-old man with stage IIIa squamous cell carcinoma of the lung who underwent a lower and middle bilobectomy after receiving neoadjuvant chemoradiation. His postoperative course was complicated by empyema and a bronchopleural fistula. Because of difficulty accessing the fistula, endobronchial-guided vascularized tissue flaps were successfully used to close the fistula...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28626910/intravenous-and-intracavitary-use-of-contrast-enhanced-ultrasound-in-the-evaluation-and-management-of-complicated-pediatric-pneumonia
#10
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/28621574/endovascular-plug-for-internal-carotid-artery-occlusion-in-the-management-of-a-cavernous-pseudoaneurysm-with-bifrontal-subdural-empyema-technical-note
#11
Sunil Manjila, Gagandeep Singh, Obinna Ndubuizu, Zoe Jones, Daniel P Hsu, Alan R Cohen
The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema. They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors' institution...
June 16, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28616283/the-use-of-thrombolytics-in-the-management-of-complex-pleural-fluid-collections
#12
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/28614864/-the-patient-with-chest-trauma-surgical-management
#13
Patrick Zardo, Henning Busk, Stefan Piatek, Norman Zinne, Irina Kropivnitskaya, Ingo Kutschka
Even though isolated cases of penetrating chest wounds are exceptionally rare in Germany, chest trauma accounts for major morbidity and mortality in over 18 0000 multitrauma patients encountered every year. Injuries range from immediately fatal cardiac wounds and major vessel lacerations to intercostal bleeding, parenchymal damage, chronic haematothorax and secondary empyema. Placement of large-bore chest tubes constitutes a sufficient treatment for most of these pathologies. In select cases further treatment either by minimally invasive techniques (VATS) or conventional thoracotomy is warranted...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28545901/management-of-aspergillus-pleural-empyema-with-combined-systemic-and-intrapleural-antifungal-therapy-in-a-pediatric-patient-case-report
#14
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/28529685/computed-tomography-guided-catheter-drainage-with-urokinase-and-ozone-in-management-of-empyema
#15
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu
AIM: To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema. METHODS: Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group II); catheter drainage, urokinase and ozone (group III). Drainage was considered successful if empyema was resolved with closure of cavity, clinical symptoms were resolved, and need for any further surgical procedure was avoided...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28528049/an-old-solution-for-a-new-problem-eloesser-flap-management-of-infected-defibrillator-patches
#16
Heidi B Schubmehl, Huan Huan Sun, Jessica S Donington, Deane E Smith, Eugene A Grossi
Cardiac surgery patients with infected implantable cardioverter defibrillator hardware face high morbidity with both surgical and nonoperative management options. We present a case of infected epicardial patch defibrillator leads in a patient with prohibitively high risk of death with open surgical removal. As a less morbid alternative, an Eloesser flap was used to convert his presenting mediastinal empyema necessitans into a chronic, manageable wound.
June 2017: Annals of Thoracic Surgery
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
#17
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...
June 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#18
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
#19
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...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28449481/procalcitonin-as-preoperative-marker-for-surgery-in-advanced-parapneumonic-empyema
#20
Claudio Caviezel, Philipp Schuetz, Stephan Gerdes, Franco Gambazzi
BACKGROUND: The optimal time point for surgical management of advanced parapneumonic empyema in need of open pleurectomy and decortication remains unclear. We hypothesized that surgical outcomes will be better when procalcitonin (PCT) levels have dropped to normal ranges as evidence for resolution of the underlying pneumonia. METHODS: We retrospectively analyzed outcomes of 38 patients with advanced parapneumonic empyema who underwent open decortication and pleurectomy with available preoperative PCT (pPCT) values...
March 2017: Journal of Thoracic Disease
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