Empyema thoracis during a ten-year period. Analysis of 72 cases and comparison to a previous study (1952 to 1967)

Abstract

In this series of 72 cases of empyema, 28 patients (38.8%) had anaerobes isolated from their pleural fluid cultures. In 22 patients, anaerobes [bacteria] were the only isolates; in 6 there were also aerobes. This observed frequency (38.8%) of anaerobic empyema is notable greater than the frequency noted in an earlier study (1952-1967) while the contribution of various pathogenetic mechanisms was similar. Although closed chest tube drainage was instituted initially in 51 patients, 18 patients (35%) subsequently required additional procedures. The case-fatality ratio was 51.4% in this study compared with 46.6% in the earlier study. Twenty-two patients died during the same hospitalization period while the empyema was an active problem. Six (8.3%) of these empyema-related deaths occurred in patients without underlying disease; 16 (22.2%) were in patients with underlying diseases.