Approach to Empyema Necessitatis

Akgül, Aslı Gül; Örkı, Alpay; Örki, Tülay; Yüksel, Mustafa; Arman, Bülent

doi:10.1007/s00268-011-1035-5

Cited by 39 publications

(35 citation statements)

References 7 publications

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“…[33][34][35] Many surgeons recommend aggressive treatment including meticulous debridement and resection involving bones and cartilage. 36 This is generally followed by coverage with local musculocutaneous flaps to decrease postoperative complications and facilitate repair of pulmonary function. In the present case a less aggressive approach was taken during the first thoracotomy.…”

mentioning

confidence: 99%

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Madeo¹,

Patel²,

Gebre³

et al. 2013

GERMS

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Empyema necessitatis is an empyema that spreads outside of the pleural space involving the chest wall. Tuberculosis is the most common cause. It occurs in both immunocompetent and immunocompromised patients. Due to the long latency period and the paucity of symptoms, diagnosis can be challenging. Clinicians must have a high awareness of this disease, especially in patients from endemic regions. The disease is treatable with surgical and medical interventions. Failure to diagnose can lead to grave consequences for both the individual patient and public health. This is particularly true in endemic regions where controlling the spread of TB is challenging. We report a rare presentation of pulmonary tuberculosis in an otherwise healthy 72-year-old USA immigrant from Thailand. He presented with a painless, chronic chest wall swelling with minimal systemic symptoms. Imaging revealed empyema necessitatis. Histopathology could not give a definitive diagnosis because the tissue was too necrotic. Despite negative acid-fast staining, sputum cultures were positive for tuberculosis. The case presentation is followed by a brief review of the current relevant literature. This case highlights the importance of clinical suspicion and increased awareness for this silent but serious infection.

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mentioning

confidence: 99%

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Madeo¹,

Patel²,

Gebre³

et al. 2013

GERMS

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“…In this study, the pulmonary complication rate was 20%, which is consistent with rates in open procedures. All lung complications including atelectasis, hemopneumothorax, pneumonia and empyema improved with perioperative pulmonary therapy, which has been previously described [1,7]. These pulmonary complications are usually due to lung parenchyma laceration during mobilization of adhesed lungs, and mild or moderate lung lacerations can be repaired through mini-open access.…”

Section: Discussionmentioning

confidence: 90%

Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up

Wang

Jing

et al. 2011

Eur Spine J

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“…Mortality from recent cases were also associated with reduced immune defence such as old age8, neoplastic9, or cystic fibrosis10. Although there has been no recent case of mortality reported with patients on dialysis, higher mortality is expected.…”

Section: Discussionmentioning

confidence: 99%

Empyema Necessitatis in a Patient on Peritoneal Dialysis

et al. 2014

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Empyema necessitatis is a rare complication of an empyema. Although the incidence is thought to be decreased in the post-antibiotic era, immunocompromised patients such as patients with chronic kidney disease on dialysis are still at a higher risk. A 56-year-old woman on peritoneal dialysis presented with an enlarging mass on the right anterior chest wall. The chest computed tomography scan revealed an empyema necessitatis and the histopathologic findings revealed a granulomatous inflammation with caseation necrosis. The patient was treated with anti-tuberculous medication.

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Approach to Empyema Necessitatis

Abstract: Surgery plays a critical role in the management of empyema necessitatis in selected patients. Tube drainage, open drainage, and decortication are the choices in variable conditions for obliterating the cavity and regenerating pulmonary function.

Cited by 39 publications

References 7 publications

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Tuberculous Empyema Presenting as a Persistent Chest Wall Mass: Case Report

Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up

Empyema Necessitatis in a Patient on Peritoneal Dialysis

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