Table of Contents

2017 Month : December Volume : 6 Issue : 93 Page : 6688-6694

EMPYEMA THORACIS- A COMPARATIVE ANALYSIS OF TUBERCULOUS AND NON-TUBERCULOUS AETIOLOGY.

Tarigopula Pramod Kumar1, G. Ramulu2, M.G. Krishna Murthy3, Prapulla Chandra D4

Corresponding Author:
Dr. Tarigopula Pramod Kumar,
H. No. 6-2-116 (B-116),
Near Rythu Bazar, Saheb Nagar Kalan,
Vanasthalipuram, Hyderabad- 500 070, Telangana.
E-mail: mdrtbchest8@gmail.com

ABSTRACT

BACKGROUND

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 one-and-a-half-year period with the objective of comparing the aetiology, clinical profiles and outcomes of patients with tuberculous and non-tuberculous empyema.

The objective of this study is to study the tuberculous and non-tuberculous patterns in the aetiology of empyema.

MATERIALS AND METHODS

This was a prospective observational study of adult patients of non-surgical thoracic empyema admitted in Govt. General and Chest Hospital, Gandhi Medical College, Secunderabad, was performed over a period of 18 months. A comparative analysis of aetiology, clinical characteristics and treatment outcomes of patients with tuberculous and non-tuberculous empyema was carried out.

RESULTS

52 cases were seen during the study period of which 30 (57.7%) cases were of non-tuberculous aetiology, whereas tuberculosis constitute 22 cases (42.3%). Among the non-tuberculous aetiology, Gram negative organisms constitute 15 (28.8%) cases and Gram positive 8 (15.3%) cases. In Tuberculous empyema mean age of presentation was 35.8 years and 44.46 yrs. in non-tuberculous empyema. Average duration of symptom presentation in tuberculous and non-tuberculous empyema are 40.35 days and 21.13 days respectively. Mean duration of intercostal tube drainage in tuberculous empyema was 33.55 days vs 18.36 days in non-tuberculous empyema. Bronchopleural fistula was present in 54.54% of tuberculous versus 20% of non-tuberculous empyema.

CONCLUSION

Tuberculous empyema remains a common cause of empyema thoracis in a country like India. Tuberculous empyema differs from non-tuberculous empyema in the age profile, clinical presentation and outcome with earlier presentation, prolonged course of disease and bronchopleural fistula formation requiring surgical intervention. Further studies are needed to evaluate the role of rapid diagnostic tools like CBNAAT with reliable sensitivity and specificity in the diagnostic algorithm for the early diagnosis of tuberculous empyema which would help in planning the treatment of empyema.

KEYWORDS

Tuberculosis, Non-Tuberculous, Empyema, CBNAAT, Bacteriological Profile, Intercostal Tube Drain (ICTD), AFB-Acid Fast Bacilli, Empyema Thoracis,1,2 Pyopneumothorax.

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