Document Detail


Clinical characteristics and outcomes of empyema thoracis in 117 patients: a comparative analysis of tuberculous vs. non-tuberculous aetiologies.
MedLine Citation:
PMID:  17045789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Empyema thoracis remains a major problem in developing countries. Clinical outcomes in tuberculous empyema are generally believed to be worse than in non-tuberculous aetiologies because of the presence of concomitant fibrocavitary parenchymal disease, frequent bronchopleural fistulae and poor general condition of patients. We performed a prospective study over a 2-year period with the objective of comparing the clinical characteristics and outcomes of patients with tuberculous vs. non-tuberculous empyema. METHODS: Prospective study of all cases of non-surgical thoracic empyema seen at a tertiary care centre in North India over a 2-year period. A comparative analysis of clinical characteristics, treatment modalities and outcomes of patients with tuberculous vs. non-tuberculous empyema was carried out. Factors associated with poor outcomes were analysed using multivariate logistic regression. RESULTS: One hundred and seventeen cases of empyema were seen in the study period of which 95 had non-tuberculous and 41 had tuberculous empyema. Malnutrition and bronchopleural fistulae (BPF) were more common and duration of symptoms longer in the tuberculous empyema group. Time to resolution of fever, duration of pleural drainage and pleural thickening >2 cm were significantly greater as well. Eight (10.5%) patients with non-tuberculous empyema and four (9.8%) with tuberculous empyema succumbed. Presence of a BPF was significantly associated with poor outcomes on multivariate logistic regression analysis. CONCLUSIONS: Tuberculous empyema remains a common cause of thoracic empyema in India though it ranked second amongst all causes of empyema after community acquired lung infections in this study. Tuberculous empyema is associated with longer duration of symptoms, greater duration of pleural drainage and more residual pleural fibrosis.
Authors:
P Malhotra; A N Aggarwal; R Agarwal; P Ray; D Gupta; S K Jindal
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-10-12
Journal Detail:
Title:  Respiratory medicine     Volume:  101     ISSN:  0954-6111     ISO Abbreviation:  Respir Med     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-09     Completed Date:  2007-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  423-30     Citation Subset:  IM    
Affiliation:
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. dranshupuneet@yahoo.co.in
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Infective Agents / therapeutic use
Bronchial Fistula / complications,  epidemiology
Drainage
Empyema, Pleural / drug therapy,  epidemiology*,  etiology
Empyema, Tuberculous / drug therapy,  epidemiology,  etiology
Female
Fistula / complications,  epidemiology
Humans
India / epidemiology
Male
Middle Aged
Nutrition Disorders / complications,  epidemiology
Pleura / pathology
Pleural Diseases / complications,  epidemiology
Pleural Effusion / microbiology
Prospective Studies
Respiratory Tract Infections / complications,  drug therapy,  epidemiology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Infective Agents

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