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A study of empyema thoracis and role of intrapleural streptokinase in its management

BACKGROUND: Clinical spectrum, microbiology and outcome of empyema thoracis are changing. Intrapleural instillation of fibrinolytic agents is being increasingly used for management of empyema thoracis. The present study was carried out to describe the clinical profile and outcome of patients with em...

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Autores principales: Banga, Amit, Khilnani, GC, Sharma, SK, Dey, AB, Wig, Naveet, Banga, Namrata
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC459221/
https://www.ncbi.nlm.nih.gov/pubmed/15222893
http://dx.doi.org/10.1186/1471-2334-4-19
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author Banga, Amit
Khilnani, GC
Sharma, SK
Dey, AB
Wig, Naveet
Banga, Namrata
author_facet Banga, Amit
Khilnani, GC
Sharma, SK
Dey, AB
Wig, Naveet
Banga, Namrata
author_sort Banga, Amit
collection PubMed
description BACKGROUND: Clinical spectrum, microbiology and outcome of empyema thoracis are changing. Intrapleural instillation of fibrinolytic agents is being increasingly used for management of empyema thoracis. The present study was carried out to describe the clinical profile and outcome of patients with empyema thoracis including those with chronic empyema and to study the efficacy and safety of intrapleural streptokinase in its management. METHODS: Clinical profile, etiological agents, hospital course and outcome of 31 patients (mean age 40 ± 16 years, M: F 25: 6) with empyema thoracis treated from 1998 to 2003 was analyzed. All patients were diagnosed on the basis of aspiration of frank pus from pleural cavity. Clinical profile, response to therapy and outcome were compared between the patients who received intrapleural streptokinase (n = 12) and those who did not (n = 19). RESULTS: Etiology was tubercular in 42% of the patients (n = 13) whereas the rest were bacterial. Amongst the patients in which organisms could be isolated (n = 13, 42%) Staphylococcus aureus was the commonest (n = 5). Intrapleural streptokinase was instilled in 12 patients. This procedure resulted in increase of drainage of pleural fluid in all patients. Mean daily pleural fluid drainage after streptokinase instillation was significantly higher for patients who received intrapleural streptokinase than those who did not (213 ml vs 57 ml, p = 0.006). Only one patient who was instilled streptokinase eventually required decortication, which had to be done in five patients (16.1%). Mean hospital stay was 30.2 ± 17.6 days whereas two patients died. CONCLUSIONS: Tubercular empyema is common in Indian patients. Intrapleural streptokinase appears to be a useful strategy to preserve lung function and reduce need for surgery in patients with late stage of empyema thoracis.
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spelling pubmed-4592212004-07-16 A study of empyema thoracis and role of intrapleural streptokinase in its management Banga, Amit Khilnani, GC Sharma, SK Dey, AB Wig, Naveet Banga, Namrata BMC Infect Dis Research Article BACKGROUND: Clinical spectrum, microbiology and outcome of empyema thoracis are changing. Intrapleural instillation of fibrinolytic agents is being increasingly used for management of empyema thoracis. The present study was carried out to describe the clinical profile and outcome of patients with empyema thoracis including those with chronic empyema and to study the efficacy and safety of intrapleural streptokinase in its management. METHODS: Clinical profile, etiological agents, hospital course and outcome of 31 patients (mean age 40 ± 16 years, M: F 25: 6) with empyema thoracis treated from 1998 to 2003 was analyzed. All patients were diagnosed on the basis of aspiration of frank pus from pleural cavity. Clinical profile, response to therapy and outcome were compared between the patients who received intrapleural streptokinase (n = 12) and those who did not (n = 19). RESULTS: Etiology was tubercular in 42% of the patients (n = 13) whereas the rest were bacterial. Amongst the patients in which organisms could be isolated (n = 13, 42%) Staphylococcus aureus was the commonest (n = 5). Intrapleural streptokinase was instilled in 12 patients. This procedure resulted in increase of drainage of pleural fluid in all patients. Mean daily pleural fluid drainage after streptokinase instillation was significantly higher for patients who received intrapleural streptokinase than those who did not (213 ml vs 57 ml, p = 0.006). Only one patient who was instilled streptokinase eventually required decortication, which had to be done in five patients (16.1%). Mean hospital stay was 30.2 ± 17.6 days whereas two patients died. CONCLUSIONS: Tubercular empyema is common in Indian patients. Intrapleural streptokinase appears to be a useful strategy to preserve lung function and reduce need for surgery in patients with late stage of empyema thoracis. BioMed Central 2004-06-29 /pmc/articles/PMC459221/ /pubmed/15222893 http://dx.doi.org/10.1186/1471-2334-4-19 Text en Copyright © 2004 Banga et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research Article
Banga, Amit
Khilnani, GC
Sharma, SK
Dey, AB
Wig, Naveet
Banga, Namrata
A study of empyema thoracis and role of intrapleural streptokinase in its management
title A study of empyema thoracis and role of intrapleural streptokinase in its management
title_full A study of empyema thoracis and role of intrapleural streptokinase in its management
title_fullStr A study of empyema thoracis and role of intrapleural streptokinase in its management
title_full_unstemmed A study of empyema thoracis and role of intrapleural streptokinase in its management
title_short A study of empyema thoracis and role of intrapleural streptokinase in its management
title_sort study of empyema thoracis and role of intrapleural streptokinase in its management
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC459221/
https://www.ncbi.nlm.nih.gov/pubmed/15222893
http://dx.doi.org/10.1186/1471-2334-4-19
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