Empyema Thoracis in Zaria; a Preliminary Report

Abstract

Aims and Objective
To study the nature and pattern of presentation of empyema thoracis (and the association between duration or time of presentation and educational level and level of income respectively), the aetiology, and different treatment outcomes.                                                                Materials and Methods
A prospective study of all patients who presented with Empyema Thoracis between January 2008 to May 2010 was carried out at ABUTH Zaria. The
diagnosis of empyema thoracis was entertained from either the presence of pus in the pleural space or the culture of actively multiplying bacteria in a serous Data was analysed with SPSS 15.
Results
A total of 26 patients were managed, 19(73.1%) men, 7(26.9%) women. There were 4(15.4%) acute and 22(84.6%) chronic empyema. One male had bilateral chronic empyema giving 13 right-sided, and 14 left-sided empyema. Tuberculosis was responsible for 26.9% of the cases, 38.4% were postpneumonic, while postoperative, and AIDS were each responsible for 11.5% and trauma 7.7%. Five patients had decortication, 2 had rib resection and open drainage, and the remainder were managed on tube thoracostomy. Two patients were discharged against medical advice, 6 were lost during follow-up. Fourteen (53.8%) were educated (1 acute and 13 chronic). Twelve (46.2 %) were uneducated (3 acute and 9 chronic). Fourteen patients (2 acute and 12 chronic) earned average or above average income while 12 (46.2%) earned below average income (2 acute and 10 chronic). There was no association between duration of presenting complaints and level of education or level of income (Fisher's exact test was, 0.306 and 1.000, respectively) at a P value of 0.05.                          Conclusion
Empyema thoracis is persistent and prevalent in our environment despite improvements in diagnosis, treatment and prevention. Most patients present late and this is not related to income or level of education. The commonest organism isolated from empyema fluid in developing countries is Staphylococcus aureus but most empyema fluid are sterile due to prolong antibiotic use. The factors responsible for delayed presentation, the pattern of presentation and the pathology and outcome of treatment is part of an ongoing study.

Key Words: Empyema Thoracis, Presentation, Aetiology, Treatment