Empyema, Biology

Empyema:

Empyema is accumulation of  thick pus in the pleural cavity. Primary infection of pleura does not arise so the pathology may either be in chest wall, mediastinum or the lungs which needs to be traced out. It  is fairly common in infants. 

Etiology 

The common causative organisms are staphylococcus.  Pneumococcus, streptococcus and H. influenzae. It  may also occur due to repture or lung abscess or subphrenic abscess into the pleural space or extension of  infection from mediastinum or osteomyelitis of  the rib, infection during cardiothoracic  surgery or penetrating injuries of chest.  

Assessment

Clinical features  resemble pneumonia  and include fever with chills,  dyspnoea, cough with sputum, chest pain and pleuritic pain which may be referred to  abdomen and toxemia.  In case,of  severe respiratory distress child may be cyanotic.  In  later stage child may develop clubbing, anaemia  and other manifestation  of malnutrition. Chest signs  include diminished movements of the affected side, widening  and fullness or intercostal spaces, dull percussion  note, diminished  air entry and mediastinal shift  to  the opposite  side. 

Empyema may involve whole pleural space i.e. total empyema or only a part of it called as loculated or encysted empyema. 

Diagnostic evaluation include X-ray chest showing diffuse density suggestive  of pleural fluid.  In most of the cases the opacities are basal and costophrenic angle is obliterated.  Pleural tap  is done  to examine  the pleural fluid biochemically  and bacteriologically.  If this  shows,  streptococcus, staphylococcus  or pneumococcus, then empyema is due to complication of bacterial pneumonia.  In aspiration pneumonia  there will be mixed flora. Presence of E.coli in the pus shows repture of subphrenic abscess. Blood examination shows polymorphonuclear  leukoyctosis with raised  total count. 

Management 

Antibiotics  are administrered as prescribed as soon as the diagnosis has been made. In such cases, closed chest drainage is indicated. If patient has fever, antipyretic drugs may be given and accurate temperature record should be maintained. Adequate fluid intake and high protein and high calorie diet must be given to the patient. If needed, blood  transfusion is also  given. 

Thoracatomy or surgical drainage after rib resection is indicated if the patient  continuesto have severe respiratory distress and when there is no improvement after 3 weeks of thereapy.

Posted Date: 10/26/2012 8:20:57 AM | Location : United States







Related Discussions:- Empyema, Assignment Help, Ask Question on Empyema, Get Answer, Expert's Help, Empyema Discussions

Write discussion on Empyema
Your posts are moderated
Related Questions
Q. Dietary Guidelines fur hyperlipidemic patients? • Calories: to maintain ideal body weight. • Carbohydrates should constitute 55-65% of calories with emphasis on • polysacc

Define Importance of nutritional requirements for management of emergencies? Knowledge of nutritional requirements for management of emergencies is therefore, important due to

Give the salient features of phylum protozoa

Septa prevent oxygenated and deoxygenated blood. Give reason

Q. Into which type of energy is the light used in photosynthesis transformed? The luminous energy used in the photosynthesis is transformed in to the chemical energy.

How do the repairing enzymes of the genetic system act? There are enzymes within the cells that detect errors or alterations in DNA molecules and start a repair of those errors

Q. Why are lysosomes known as "the cleaners" of the cell waste? Lysosomes carry out heterophagic and autophagic digestion autophagic digestion by digesting residual substances


Circulatory System - Developmental Changes We have learnt that throughout foetal life, gas exchange takes place, only through the placenta and not through lungs. Therefore, t

Explain the repair mechanisms of brain Scientists are just beginning to understand how these innate repair mechanisms might be harnessed to treat disease. On leading edge of th