|
KMID : 0371319690110050295
|
|
Journal of the Korean Surgical Society
1969 Volume.11 No. 5 p.295 ~ p.300
|
|
|
Empyema Following Staphylococcal Pneumonia
|
|
李世淳/Lee, Sae Soon
洪承祿/徐相賢/金相玉/金光洙/李庸彰/Hong, Sung Nok/Suh, Sang Hyon/Kim, Sang Ok/Kim, Gwang Soo/Lee, Yong Chang
|
|
|
Abstract
|
|
|
Staphylococcal empyema as a complication of staphylococcal pneumonia has assumed particular attention in recent years, because of increasing incidence of antibiotic-resistant strains, and hasbeen discussed repeatedly.
The purpose of this article is to report a study of 57 cases of staphylococcal empyema which hasfollowed staphylococcal pneumonia and treated in Severance Hospital over a period of 10 yearsfrom 1959 through 1968.
There were 260 cases of thoracic empyema during 10 years, among which empyema of staphylococcal pneumonia origin numbered 57 cases. And the remainders were those of tuberculosis originor bacteria other than staphylococcus, or those of post-lobectomy complications.
Among 57 cases of this series, staphylococci were cultured from pus in 49 cases and remaining 8cases were included in this series because the bacteria was found in throat swab. 55 cases (96.5% )of staphylococcal empyema were infant or children below 15 years of age and only 2 occurred inyoung adults. On the contrary, the most of adult empyema was those of tuberculosis origin.The sex incidence showed male preponderance by 2.8 to 1 ratio. 54 cases(94.7%) were unilaterallyinvolved and 3(5.3%) bilaterally, and all of those three succumbed.
By bacterial culture and sensitivity test, 65.3 belonged to coagulase-positive strain and 12.2% tocoagulase-negative, and 22.5% unclassified. Many of these strains were resistant to antibioticsespecially to penicillin, but if were there any sensitive drugs these were administered along withsurgical intervention.
In all patients thoracentesis was performed as a diagnostic measure preoperatively and 6 casesof them were cured only by aspiration and antibiotics, but 1 case who had only thoracentesis died.This procedure was applied not on the purpose of treatment but there was no more pus accumulationafter this procedure. The majority, 44 cases (77.2%), had closed drainage after diagnostic confirmation, and 11 cases of them had been converted to open drainage later. There were 2 deathsamong closed drainage group. In 6 cases open drainage was performed from beginning. There were 4 cases of overall mortality.
Considering mortality rate rate and hospitalized date, the result of treatment was best in closed drainage group. Accordingly authors insist that immediate closed drainage is indicated as a management of staphylococcal empyema to prevent further progress of more serious complications.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|