Clinical and microbiological evaluation of empyema thorasis

Abstract

Objectives: Comparing the clinical & microbiological profiles of patients with tuberculosis and nontuberculosis empyema. Materials and Methods: A prospective study of adult cases of nonsurgical thoracic empyema admitted in a tertiary care hospital in warangal :telangana state was performed over a period of 18 months. A comparative analysis of clinical characteristics, treatment modalities, and outcomes of patients with tuberculosis and nontuberculosis empyema was carried out. Results: Fifty cases of empyema were seen during the study period, of which 24 (,48%) were of nontuberculosis etiology while tuberculosis constituted 26(, 52%) cases. Among the nontuberculosis empyema patients, pseudomonas 8( 16%) was the most frequent pathogen isolated. Tuberculosis empyema was more frequent in younger population compared to nontuberculosis empyema (mean age of 30.6 years vs. 48.5 years). Duration of illness and mean duration of chest tube drainage were longer (40.7 vs. 20.2 days) in patients with tuberculosis empyema. Also the presence of parenchymal lesions and bronchopleural fistula often requiring surgical drainage procedures was more in tuberculosis empyema patients. Conclusion: Tuberculosis empyema remains a common cause of empyema thoracis in a country like India. Tuberculosis empyema differs from nontuberculosis empyema in the age profile, clinical presentation, management issues, and has a significantly poorer outcome