Disease relevance of Empyema

• The incidence of empyema was similar in both groups; nevertheless, the presence of bacteremia and septic shock was more frequent in the MRSA group [1].
• The series comprised seven patients with RA and 115 patients with other diseases including systemic lupus erythematosus, tuberculosis, malignant disease, empyema, pneumonia, congestive heart failure, and nonspecific pleural effusion [2].
• The aminoglycoside antibiotic tobramycin was given intramuscularly to 15 patients with infected body fluids (empyema in five patients, peritonitis in five, peritonitis and empyema in one, tracheobronchitis in three, and infection of the pacemaker pocket in one) [3].
• Eighty one effusions (62.8%) were tuberculous, 12 (9.3%) parapneumonic, and 10 (7.7%) neoplastic, five were caused by pulmonary thromboembolism, four by systemic lupus erythematosus, seven by empyema, three following surgery, one was the result of asbestosis, and one of nephrotic syndrome [4].
• Bacteriological and symptomatic failure occurred in one patient with Ps. aeruginosa lung abscess treated with cefoperazone and in one patient with a polymicrobial empyema treated with cefamandole [5].

High impact information on Empyema

• IL-8 levels were higher in empyema fluid than in parapneumonic effusions (p = 0.01) [6].
• Our study with ticarcillin plus clavulanic acid included seven patients with pneumonia, one with empyema, and one with purulent tracheobronchitis [7].
• PF IL-8, NE, and MPO concentrations in cases of empyema were higher than in cases of effusion of other causes (p < 0.001) [8].
• Pleural diffusion of voriconazole in a patient with Aspergillus fumigatus empyema thoracis [9].
• Eosinophilic "empyema" associated with crack cocaine use [10].

Chemical compound and disease context of Empyema

• Gentamicin persisted in the empyema longer than in blood [11].
• The patient responded to cefotaxime (MIC, 0.25 microg/ml) treatment and drainage of the empyema [12].
• The determination of pleural fluid lactic acid may help in differentiating between empyema and nonbacterial pleural effusions in most cases [13].
• After an empyema was verified by thoracentesis and pleural fluid analysis, penicillin, 24,000 U/kg; metronidazole, 37 mg/kg; ceftriaxone, 30 mg/kg; clindamycin, 9 mg/kg; vancomycin, 15 mg/kg; or gentamicin, 1 mg/kg, were administered IV [14].
• Two patients had beta-lactamase producing isolates, one of whom developed an empyema, following treatment with ampicillin, which required surgical drainage [15].

Biological context of Empyema

• The histology of experimental pleural injury with tetracycline, empyema, and carrageenan [16].
• METHODS: Serum IgG, IgA, IgM, Complement C3 assay and cell mediated immunity (CMI) tests were performed in 33 patients of empyema thoracis, and 14 healthy age matched controls [17].

Anatomical context of Empyema

• There was a significant correlation between IL-8 levels and the total numbers of neutrophils in empyema fluids (r = 0.80) [6].
• VEGF levels were also significantly raised compared with transudates (median 36.5 pg/ml) in empyema (4651 pg/ml (95% CI 833 to 10 000), p<0.001) and parainfectious effusions (360 pg/ml (95% CI 46 to 597), p<0.005) [18].
• Calculi were found in six ureters and neoplasms in five; ureteritis cystica developed in one, infection secondary to vesicoureteral reflux in one, and empyema proximal to an obstructed ectopic ureteral orifice in another [19].
• An Indium-111-labeled leukocyte scan was also performed in this patient and demonstrated abnormal uptake in the empyema [20].
• In tuberculosis, empyema and rheumatoid arthritis ADA activity was significantly higher in pleural fluid than in serum, indicating a local synthesis of ADA by cells within the pleural cavity in these diseases [21].

Gene context of Empyema

• Compared to noncomplicated PPE, complicated PPE/empyema had significantly higher levels of TNF-alpha, IL-1beta, IL-8 and MIP-1beta [22].
• Among exudates, tuberculous, empyema and complicated parapneumonic effusions demonstrated higher pleural PAI levels than malignant effusions, whereas t-PA was lowest in empyema and complicated parapneumonic pleural effusions [23].
• The study revealed that TFPI was present in transudates from patients with CHF and exudative pleural effusions from patients with pneumonia, empyema or pleural carcinoma [24].
• A negative association found between t-PA and both IL-8 and polymorphonuclear elastase in exudative effusions was strongest in empyema and complicated parapneumonic effusions [23].
• Our results also indicate that the high levels of IL-8 and G-CSF in empyema may indirectly explain the elevated levels of defensins by increasing the number of neutrophils in the pleural space [25].

Analytical, diagnostic and therapeutic context of Empyema

• Pseudoallescheria boydii pneumonia and empyema: a rare complication of heart transplantation cured with voriconazole [26].
• Chest tube-related empyema due to methicillin-resistant Staphylococcus aureus: could the chest tube be coated with antiseptics [27]?
• Furthermore, a low CRP value after pneumonectomy (less than 50 mg/L) may help in deciding whether to confidently discharge a patient from the hospital in the absence of empyema [28].
• We describe two patients with CF who, after double lung transplantation, developed the unusual complication of empyema and empyema necessitatis due to P cepacia that was resistant to all tested antibiotics [29].
• Of the 31 children treated for empyema thoracis secondary to pneumonitis at the Loma Linda University Medical Center, Loma Linda, Calif, from 1980 to 1990, 23 responded to prompt directed antibiotic therapy coupled with drainage, usually tube thoracostomy [30].

References