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empyema management

Jessica Y Ng, Jennie Gu
Acute acalculous cholecystitis is an uncommon disease in children and is usually associated with trauma, burns, and infections. Whereas acute acalculous cholecystitis is only seen in 10% of cholecystitis in adults, it is uncommon in the paediatric population. A seven-year-old male presented to the emergency department of a regional hospital with a 36-hour history of right-upper-quadrant abdominal pain. He had associated symptoms of anorexia, nausea, and vomiting. He was septic with raised white cell count and inflammatory markers...
January 20, 2018: Curēus
Christopher Ull, Mirko Aach, Josef Reichert, Thomas Armin Schildhauer, Justyna Swol
Pulmonary infections are life-threatening complications in patients with spinal cord injuries. In particular, paraplegic patients are at risk if they are ventilator-dependent. This case history refers to a spinal cord injury with a complete sensorimotor tetraplegia below C2 caused by a septic scattering of an intraspinal empyema at C2-C5 and T3-T4. A right-sided purulent pneumonia led to a complex lung infection with the formation of a pleuroparenchymal fistula. The manuscript describes successful, considerate, non-surgical management with shortterm separate lung ventilation...
January 29, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Tara R Semenkovich, Margaret A Olsen, Varun Puri, Bryan F Meyers, Benjamin D Kozower
BACKGROUND: Empyema affects up to 65,000 patients annually in the United States. Recent consensus guidelines demonstrate ambiguity about optimal treatment. We examined current treatment practices and outcomes for inpatient treatment of empyema using a comprehensive, longitudinal dataset that encompasses an entire state cohort of hospitalized patients. METHODS: We queried the Healthcare Cost and Utilization Project (HCUP) New York State Inpatient Database (2009-2014) for patients with primary empyema and subsequent readmissions...
March 14, 2018: Annals of Thoracic Surgery
Marjolaine Morgand, Alexandre Leclercq, Mylène M Maury, Hélène Bracq-Dieye, Pierre Thouvenot, Guillaume Vales, Marc Lecuit, Caroline Charlier
OBJECTIVES: Listeria monocytogenes (Lm) is a foodborne human pathogen responsible for severe infection, including septicemia, neurolisteriosis, maternal-fetal and focal infections. Little is known about Lm-associated respiratory tract or lung infections. METHODS: Retrospective study of culture-proven cases of Lm pleural infections and pneumonia reported to the French National Reference Center for Listeria from January 1993 to August 2016. RESULTS: Thirty-eight consecutive patients with pleural infection (n=32), pneumonia (n=5), or both (n=1) were studied...
March 13, 2018: Clinical Microbiology and Infection
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
Eva Teng, Luke Bennett, Tommaso Morelli, Anindo Banerjee
We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Serial chest x-rays showed progression from lobar consolidation to a large loculated left-sided pleural collection. CT chest showed left-sided lung abscess, empyema and bronchopleural fistulation...
February 5, 2018: BMJ Case Reports
J Matthew Reinersman, Mark S Allen, Shanda H Blackmon, Stephen D Cassivi, Francis C Nichols, Dennis A Wigle, K Robert Shen
BACKGROUND: Persistent air leak can complicate pulmonary resection, and one management option is dismissal with a chest tube in place. This study evaluated the rate of empyema and readmission after dismissal with a chest tube. METHODS: A retrospective review of our prospective database from January 2004 to December 2013 identified 236 patients who were discharged from our institution with an indwelling chest tube and attached one-way valve for air leak. Empyema was defined by leukocytosis or fever and undrained effusion on chest roentgenogram or computed tomography...
February 1, 2018: Annals of Thoracic Surgery
Kenneth V I Rolston, Lior Nesher
Published literature on post-obstructive pneumonia is difficult to find and consists mainly of case reports or small case series. This entity is encountered most often in patients with advanced lung malignancy but is also occasionally seen in patients with community-acquired pneumonia (CAP). There are substantial differences in the manifestations, treatment, and outcomes of post-obstructive pneumonia in these two settings. When obstruction is present in patients with CAP, it is almost always secondary to an underlying pulmonary malignancy...
February 1, 2018: Infectious Diseases and Therapy
Maxime Erlem, Raphaël Guiheneuf, Nathalie Klopp-Dutote, Aurélie Biet-Hornstein, Loïc Dégrugilliers, Cyril Page
In the Picardie region of northern France, the prevalence of intracranial suppurative complications (particularly empyema) of ear, nose and throat infections seems to have increased over the last 10 to 15 years. Three possible reasons for the increased incidence in this region are the inappropriate use of antibiotics, low socioeconomic status, and poor access to high-quality healthcare. Intracranial complications affect both sexes and all ages. If a patient suffering from sinusitis or (especially) otitis media complains of headache, the possible presence of an intracranial suppurative complication must be always be considered and should prompt immediate medical imaging (a cranial CT scan and MRI) for confirmation of the diagnosis...
January 27, 2018: Clinical Otolaryngology
Ali Akil, Jan Reichelt, Stefan Freermann, Ilias Karfis, Michael Semik, Stefan Fischer
OBJECTIVES: Persistent air leak or bronchopleural fistula (BPF) is a challenging and frequently observed problem after pulmonary resection and may lead to prolonged chest tube therapy. One efficient nonsurgical approach to manage such a fistula is the application of intrabronchial valves. This may support earlier chest tube removal and hospital discharge. METHODS: Between 04/2015 and 03/2017, n = 8 patients (n = 4 female) with severe pleural empyema and necrotising lung tissue defects developed prolonged air leak and persistent BPF after surgery...
January 17, 2018: Zentralblatt Für Chirurgie
Julie B Guerin, Diana L Vork, Lourdes Eguiguren, Alexander P Marston, Colin L W Driscoll, Matthew L Carlson, Nancy K Henry, John I Lane
OBJECTIVE: To report the presentation, diagnosis, management, and convalescence of labyrinthine sequestrum (LS) and summarize all previously published cases. PATIENT(S): Eleven-year-old female with LS. INTERVENTION(S): Multidisciplinary diagnostic evaluation and treatment. MAIN OUTCOME MEASURES: Imaging and laboratory findings, medical and surgical treatment. RESULTS: We describe a case of LS secondary to medically recalcitrant suppurative otitis media in an 11-year-old female and review all eight previously reported cases...
March 2018: Otology & Neurotology
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: Eastern Association for the Surgery of Trauma guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to (1) determine the safety of selective observation for traumatic hemothorax and (2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000 to 2014 at a Level I trauma center were identified and categorized by size as small (<300 cc) or large (≥300 cc) based on chest computed tomography (CT) scan measurements...
March 2018: Journal of Trauma and Acute Care Surgery
Renu Suthar, Naveen Sankhyan
Bacterial infections of the central nervous system (CNS) continue to be an important cause of morbidity and mortality in children. The spectrum of bacterial infection of CNS includes; focal or multifocal infections like brain abscesses or subdural empyema; or more generalized or diffuse infections like pyogenic meningitis or ventriculitis. Focal and generalized infections may co-exist in an individual patient. Prompt and adequate antibiotic therapy and occasionally neurosurgical interventions are the cornerstone of effective management...
January 3, 2018: Indian Journal of Pediatrics
I Issoufou, M Lakranbi, L Belliraj, F Z Ammor, H Harmouchi, Y Ouadnouni, M Smahi
INTRODUCTION: Tuberculous pyothorax or empyema is one of the serious forms of tuberculosis and still poses public health problems. Through a series of patients who undergone pleuropulmonary decortication, we propose our model of management and determine the main factors prognostic. METHOD: We retrospectively retrieved for 8 years 93 cases of patients with pleuropulmonary decortication for tuberculous pyothorax confirmed by histological examination pre- or postoperatively...
December 28, 2017: Revue de Pneumologie Clinique
Zaid Aljuboori, Mayur Sharma, Thomas Altstadt
Nocardiosis of the central nervous system and spine, in particular, is a rare infection with significant morbidity and mortality. Treatment is usually with antibiotics and surgical drainage or biopsy. The authors report a case of a 49-year-old man who presented with chronic lower back pain and paraplegia. He was found to have spinal subdural empyema caused by Nocardia farcinica. Laminectomy and sampling of the subdural collection were performed, and the patient was treated with triple intravenous antibiotics (linezolid, amikacin and ciprofloxacin)...
October 24, 2017: Curēus
Jyotiranjan Champatiray, Jyotiranjan Satapathy, Baikunthanath Kashyap, Dipankar Mondal
Introduction: Pneumonia is a major cause of mortality under five-year-old children. In spite of recent advances in management, there is paucity of data on clinical, aetiological profile of severe and very severe pneumonia among under five-year-old children in developing countries. Aim: To determine the clinico-aetiological factors of severe and very severe pneumonia and its outcome in children aged two -months to five-years in a tertiary health care centre in Odisha, India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
M C Chikani, W Mezue, E Okorie, C Mbachu, C Ndubisi, U N Chikani
BACKGROUND: Controversy regarding the best management strategy for subdural empyema (SDE) attests to the persisting poor outcomes for this uncommon life threatening intracranial suppurative process. Late presentation confounds the problem in developed countries. While craniotomy is commonly recommended, it is not always possible in late presentation with advanced morbidity. The aim of this study was to identify the pattern of clinical presentation and explore the outcomes following management of SDE using burr hole, aspiration, and drainage (BAAD) in resource poor settings...
October 2017: Nigerian Journal of Clinical Practice
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
Martin M Mortazavi, Syed A Quadri, Sajid S Suriya, Salman A Fard, Shahram Hadidchi, Farzad H Adl, Ian Armstrong, Richard Goldman, R Shane Tubbs
BACKGROUND: Subdural empyema can present as a spinal subdural empyema (SSE) or a cranial subdural empyema (CSE). Although they differ somewhat in epidemiology, etiology, pathophysiology, and symptomatology and occur separately, they rarely manifest together. The aim of this article is to review the literature concerning the clinical presentation, clinical course, and treatment options for managing concurrently occurring SSE and CSE. METHODS: The literature in the Medline database was reviewed with key words including but not limited to subdural empyema, retroclival empyema, and Streptococcus mitis...
February 2018: World Neurosurgery
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
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