DOI QR코드

DOI QR Code

Pleural Infection and Empyema

  • Kwon, Yong Soo (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School)
  • 투고 : 2014.01.27
  • 심사 : 2014.02.11
  • 발행 : 2014.04.30

초록

Increasing incidence of pleural infection has been reported worldwide in recent decades. The pathogens responsible for pleural infection are changing and differ from those in community acquired pneumonia. The main treatments for pleural infection are antibiotics and drainage of infected pleural fluid. The efficacy of intrapleural fibrinolytics remains unclear, although a recent randomized control study showed that the novel combination of tissue plasminogen activator and deoxyribonuclease had improved clinical outcomes. Surgical drainage is a critical treatment in patient with progression of sepsis and failure in tube drainage.

키워드

참고문헌

  1. Burgos J, Falco V, Pahissa A. The increasing incidence of empyema. Curr Opin Pulm Med 2013;19:350-6. https://doi.org/10.1097/MCP.0b013e3283606ab5
  2. Grijalva CG, Zhu Y, Nuorti JP, Griffin MR. Emergence of parapneumonic empyema in the USA. Thorax 2011;66:663-8. https://doi.org/10.1136/thx.2010.156406
  3. Davies HE, Davies RJ, Davies CW; BTS Pleural Disease Guideline Group. Management of pleural infection in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65 Suppl 2:ii41-53.
  4. Aleman C, Alegre J, Monasterio J, Segura RM, Armadans L, Angles A, et al. Association between inflammatory mediators and the fibrinolysis system in infectious pleural effusions. Clin Sci (Lond) 2003;105:601-7. https://doi.org/10.1042/CS20030115
  5. Kroegel C, Antony VB. Immunobiology of pleural inflammation: potential implications for pathogenesis, diagnosis and therapy. Eur Respir J 1997;10:2411-8. https://doi.org/10.1183/09031936.97.10102411
  6. Idell S, Girard W, Koenig KB, McLarty J, Fair DS. Abnormalities of pathways of fibrin turnover in the human pleural space. Am Rev Respir Dis 1991;144:187-94. https://doi.org/10.1164/ajrccm/144.1.187
  7. Maskell NA, Batt S, Hedley EL, Davies CW, Gillespie SH, Davies RJ. The bacteriology of pleural infection by genetic and standard methods and its mortality significance. Am J Respir Crit Care Med 2006;174:817-23. https://doi.org/10.1164/rccm.200601-074OC
  8. Marks DJ, Fisk MD, Koo CY, Pavlou M, Peck L, Lee SF, et al. Thoracic empyema: a 12-year study from a UK tertiary cardiothoracic referral centre. PLoS One 2012;7:e30074. https://doi.org/10.1371/journal.pone.0030074
  9. Kim YJ, Cha SI, Kwon JS, Yoo SS, Jun HJ, Kim EJ, et al. Treatment results and prognostic factors of complicated parapneumonic effusion and empyema. Tuberc Respir Dis 2007;63:24-30. https://doi.org/10.4046/trd.2007.63.1.24
  10. Menzies SM, Rahman NM, Wrightson JM, Davies HE, Shorten R, Gillespie SH, et al. Blood culture bottle culture of pleural fluid in pleural infection. Thorax 2011;66:658-62. https://doi.org/10.1136/thx.2010.157842
  11. Rahman NM, Maskell NA, Davies CW, Hedley EL, Nunn AJ, Gleeson FV, et al. The relationship between chest tube size and clinical outcome in pleural infection. Chest 2010;137:536-43. https://doi.org/10.1378/chest.09-1044
  12. Maskell NA, Davies CW, Nunn AJ, Hedley EL, Gleeson FV, Miller R, et al. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med 2005;352:865-74. https://doi.org/10.1056/NEJMoa042473
  13. Corcoran JP, Hallifax R, Rahman NM. New therapeutic approaches to pleural infection. Curr Opin Infect Dis 2013;26:196-202. https://doi.org/10.1097/QCO.0b013e32835d0b71
  14. Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med 2011;365:518-26. https://doi.org/10.1056/NEJMoa1012740
  15. Janda S, Swiston J. Intrapleural fibrinolytic therapy for treatment of adult parapneumonic effusions and empyemas: a systematic review and meta-analysis. Chest 2012;142:401-11. https://doi.org/10.1378/chest.1389892
  16. Brutsche MH, Tassi GF, Gyorik S, Gokcimen M, Renard C, Marchetti GP, et al. Treatment of sonographically stratified multiloculated thoracic empyema by medical thoracoscopy. Chest 2005;128:3303-9. https://doi.org/10.1378/chest.128.5.3303
  17. Ravaglia C, Gurioli C, Tomassetti S, Casoni GL, Romagnoli M, Gurioli C, et al. Is medical thoracoscopy efficient in the management of multiloculated and organized thoracic empyema? Respiration 2012;84:219-24. https://doi.org/10.1159/000339414
  18. Chambers A, Routledge T, Dunning J, Scarci M. Is videoassisted thoracoscopic surgical decortication superior to open surgery in the management of adults with primary empyema? Interact Cardiovasc Thorac Surg 2010;11:171-7. https://doi.org/10.1510/icvts.2010.240408
  19. Chung JH, Lee SH, Kim KT, Jung JS, Son HS, Sun K. Optimal timing of thoracoscopic drainage and decortication for empyema. Ann Thorac Surg 2014;97:224-9. https://doi.org/10.1016/j.athoracsur.2013.08.039
  20. Shin JA, Chang YS, Kim TH, Haam SJ, Kim HJ, Ahn CM, et al. Surgical decortication as the first-line treatment for pleural empyema. J Thorac Cardiovasc Surg 2013;145:933-9. https://doi.org/10.1016/j.jtcvs.2012.07.035

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