Management of Empyema Thoracic in Ratchaburi Hospital

Abstract

                Over a 3 year period (July 1988-August 1991) 32 adult patients with empyema thoracis. Tuberculous empyema and amebic empyema were treated. Causes of the empyema were post-pneumonlc in 56%, post-resectional in 6% post-traumatic in 10%, tuberculous in 19%, amebic in 3% and miscellaneous in 6%. Single causal organisms were found In 18 patients (the most common organisms included Staphylococcus aureus and L-hemohytic streptocoscus). Multiple organisms were found in 4 patients and no growth in 9, culture was not dbtained in one case.

                Thoracocentesis was performed in 31 patients, Intercostal drainage (I.C.D.) in 21 patients which was successful in 9 (43%).

                The remainder 23 patients required further sergery such as resection in 3 patients and decortication in 15 ; lobectomy and decortication in 2, thoracoplasty in 2 and pleuropueumonectomy in 1. The mortality rate was 9.31% (3 of 32 patients).