Clinical background of cases showing a positive culture of pleural effusion at Shin-Kokura Hospital over a period of 5 years |
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Authors: | Satoshi Kuboi Hideyuki Nomura |
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Institution: | (1) Department of Internal Medicine, Shin-Kokura Hospital, 1-3-1 Kanada, Kokurakita-ku, Kitakyushu 803-8505, Japan |
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Abstract: | We investigated the clinical background of patients at Shin-Kokura Hospital who showed a positive culture of pleural effusion
during the period from January 1998 through December 2002. Microorganism cultures of the pleural effusions of 127 patients
were performed in this 5-year period. Seventeen patients showed a positive microorganism culture from a pleural effusion,
and 12 of these patients (70.6%) were 60 years old or more. Ten patients were diagnosed with thoracic empyema. Thirteen patients
had an underlying disease such as malignancy (5 cases), diabetes mellitus (4 cases), etc. A purulent effusion and a high concentration
of lactic dehydrogenase (LDH) in the pleural fluid were more frequently recognized in the positive-culture group. A total
of 21 strains of microorganism were isolated from the 17 patients, including 10 strains of Gram-positive cocci, 6 strains
of Gram-negative bacilli, 3 strains of anaerobes, 1 strain of mycobacterium (Mycobacterium tuberculosis), and 1 strain of fungus. Susceptibility to antimicrobial agents was generally good for most of the microorganisms isolated.
Of the 17 patients, chest-tube drainage was performed in 13, and 6 needed a surgical operation. Twelve patients improved,
but 5 died. In this study, thoracic empyema accounted for 58.8% of the 17 cases with a positive culture of pleural effusion.
Of the 10 thoracic empyema patients, 5 patients needed surgical treatment in spite of adequate antimicrobial treatment and
chest-tube drainage. Our data indicate that thoracic empyema is still difficult to treat, and thus adequate and rapid treatment
is needed for any pleural infection. |
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Keywords: | Culture of pleural effusion Thoracic empyema Chest-tube drainage Antimicrobial treatment |
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