Title : Clinico-bacteriological profile of empyema thoracis and its outcome in a developing country like India

Abstract:

Introduction:
Thoracic empyema is a disease of significant morbidity and mortality, especially in the developing countries like India where tuberculosis remains a common cause. We performed a prospective study over 3 years with the objective of comparing the aetiology, clinical profiles and outcomes of patients with empyema in a tertiary care centre in Chennai Southern India

Materials and Methods:
This was a prospective observational study of adult patients with features of empyema admitted in our department over a period of 3 years. A comparative analysis of aetiology, clinical characteristics and treatment outcomes of 52 patients with empyema was carried out.

Results:
Out of 52 cases were seen during the study period of which 30 (58 %) cases were of bacterial aetiology, [Gram negative organisms constitute 15 (29% ) cases and Gram positive 8 (15% ) cases]. Where as mycobacterium tuberculosis diagnosed in 22 cases (42 %). 54 % were diabetic. Medical thoracoscopy were needed in 60% cases . Surgical intervention including Video assisted thoracoscopy and decortication were needed in 10% . Among final outcome 80% patients showed complete re expansion of lung .

Conclusion:
Tuberculosis still remains a common cause of empyema thoracis in a developing country like India. Early intervention with medical thoracoscopy along with intra pleural fibrinolytics and good antibiotic coverage can prevent significant morbidity and mortality