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Neumología y cirugía de tórax
versão impressa ISSN 0028-3746
Resumo
REYNA-SEPULVEDA, Francisco et al. Epidemiology and management of empyema thoracic by hepatic abscess. Neumol. cir. torax [online]. 2017, vol.76, n.2, pp.91-95. ISSN 0028-3746.
Background:
Liver abscess (LA) can be classified into two categories: amebic (AA) and pyogenic (PA) abscess. However, the most common cause of LA worldwide is amoebic. Empyema is usually a complication of pneumonia, but may arise from an adjacent infection such as the liver.
Objective:
To determine the epidemiology and to evaluate the management of patients with empyema by LA.
Material and methods:
We requested the University Hospital «Dr. José Eleuterio González» the records of 2011-2015 with diagnosis of LA and empyema.
Results:
Twenty-four patients were diagnosed with diabetes mellitus in 10 (42%). The most common symptom was abdominal pain with 18 (75%) patients, followed by fever and chills with 16 (67%), dyspnea in 12 (50%), with amoebic etiology in 4 (16%) patients and the remaining 20 (83%) was pyogenic. In all patients a thoracostomy tube for empyema drainage was placed, 14 (58%) of patients underwent thoracoscopy and two (8%) mortalities were reported.
Discussion:
The prevalence of diabetes is associated with a higher mortality in LA. The presentation of most of the cases was late and no patient came with a clinical picture of pneumonia. There are reports of some amoebic LA that cause pleural empyema but very few cases of pyogenic etiology have been documented.
Conclusions:
The prevalence of Klebsiella pneumoniae with more nonspecific clinical features may explain the delay in diagnosis. We report a lower mortality than previously established.
Palavras-chave : Empyema; liver abscess; epidemiology.