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Clin Imaging 2021 Jun 1;79:213-218. Epub 2021 Jun 1.

Ondokuz Mayis University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Samsun, Turkey.

Purpose: To investigate the utilization of 3-Tesla (3 T) magnetic resonance imaging (MRI) in detection of pulmonary abnormalities in children with pneumonia.

Materials And Methods: Forty-seven children with pneumonia prospectively underwent 3 T thoracic MRI and posteroanterior (PA) chest radiography (CR). Of these, 15 patients also underwent contrast-enhanced thorax computed tomography (CT) or high-resolution CT (HRCT). Read More

Medicine (Baltimore) 2021 Jun;100(23):e25754

Department of Thoracic Surgery.

Abstract: Our objective was to identify independent risk factors for predicting which patients in the Chinese population would likely develop respiratory failure.A descriptive analysis was conducted of demographic and clinical data of patients with tuberculous empyema (TE) admitted to the Beijing Chest Hospital, Capital Medical University between January 2001 and January 2020. Risk factors associated with postsurgical respiratory failure in TE patients were identified based on results of analyses based on univariable and multivariable logistic regression models. Read More

Thorac Cancer 2021 Jun 9. Epub 2021 Jun 9.

Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Japan.

Background: This study was performed to evaluate the clinical outcomes of hybrid treatment involving surgical resection and percutaneous radiofrequency ablation for patients with multiple lung metastases.

Methods: Seventeen patients (6 men, 11 women; median age, 52 years; range, 16-78 years) underwent hybrid treatment involving surgery and radiofrequency ablation to treat multiple lung metastases (median number, 4; range, 2-26) between May 2014 and February 2020. The primary lesions were colorectal carcinoma (n = 9), uterine endometrial carcinoma (n = 3), osteosarcoma (n = 2), renal cell carcinoma (n = 1), glottic carcinoma (n = 1), and fibrolamellar hepatocellular carcinoma (n = 1). Read More

Vet Rec 2021 Jun 7:e557. Epub 2021 Jun 7.

Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.

Background: Although, vestibular syndrome is a common neurological presentation, little is known about the diagnostic value of cerebrospinal fluid (CSF) analysis in vestibular syndrome in dogs.

Methods: Medical records were retrospectively reviewed, and dogs with vestibular disease that had undergone magnetic resonance imaging of the head, CSF analysis and were diagnosed with central or peripheral vestibular syndrome were included. Disorders affecting the central vestibular system included meningoencephalitis of unknown origin (MUO), brain neoplasia, ischaemic infarct, intracranial empyema or metronidazole toxicity. Read More

Front Surg 2021 21;8:679757. Epub 2021 May 21.

Department of Surgery, University of Milan, Milan, Italy.

Venous and arterial thromboembolism is commonly reported in critically ill COVID-19 patients, although there are still no definitive statistical data regarding its incidence. we report a case of a patient who fell ill with Covid during hospitalization for a pneumonectomy complicated by empyema and bronchopleural fistula. The patient, despite being cured of COVID, died after 14 days for pulmonary thromboembolism. Read More

Cureus 2021 May 3;13(5):e14822. Epub 2021 May 3.

Emergency Medicine, California University of Science and Medicine, Colton, USA.

An empyema necessitans is a rare complication of a collection of purulent material in the pleural space that spreads outside of the pleural cavity and involves the soft tissues of the chest wall. Due to compression forces created by the size of the collection of empyema in the chest cavity, patients are usually symptomatic and present with severe dyspnea. Chest X-ray or ultrasound of the chest cavity are the ideal screening tools to visualize the empyema and followed by computerized tomography scan of the chest to confirm the presence and extent of the pathology. Read More

New Microbes New Infect 2021 May 29;41:100892. Epub 2021 Apr 29.

Department of Thoracic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.

was first identified in 1995. To the best of our knowledge, pleural empyema caused by has never been reported. In the case reported herein, a patient with pleural empyema was treated surgically, and in the bacterial samples, was isolated. Read More

Respirol Case Rep 2021 Jul 26;9(7):e00785. Epub 2021 May 26.

Division of Thoracic Surgery Kansai Medical University Medical Center Moriguchishi Japan.

A few cases of empyema secondary to coronavirus disease 2019 (COVID-19) pneumonia have been reported. Here, we report our experience of a successful endobronchial occlusion using endobronchial Watanabe spigots (EWSs) for empyema with broncho-pleural fistula secondary to COVID-19 pneumonia. A 62-year-old man was diagnosed with COVID-19 and progressed to empyema with broncho-pleural fistula. Read More

J Indian Assoc Pediatr Surg 2021 Mar-Apr;26(2):123-125. Epub 2021 Mar 4.

Department of Paediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Langerhans cell histiocytosis is an uncommon disease of childhood. Intrathoracic transposition flaps have been described for a management of number of conditions. We discuss our experience of the use of serratus anterior flap for the obliteration of a pulmonary bulla with a communicating airway, in a 1½-year-old pediatric patient with multisystem Langerhans cell histiocytosis who presented with recurrent pneumothorax with empyema due to rupture of bullae. Read More

BMJ Case Rep 2021 Jun 2;14(6). Epub 2021 Jun 2.

Cardiothoracic Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.

At the outset of the pandemic, SARS-CoV-2 was thought to present simply as persistent cough and fever. However, with time, the medical community noted a myriad of associated symptoms well-described in the literature. Medical complications were particularly common in elderly populations and many early publications described pneumonia, organ failure, acute respiratory distress syndrome, hypercoagulability/microthrombosis and superimposed bacterial/viral infections. Read More

Cureus 2021 Apr 26;13(4):e14697. Epub 2021 Apr 26.

Internal Medicine, Arnau de Vilanova University Hospital, Lleida, ESP.

is a rare Nocardia species causing localized (lung, brain, skin) and disseminated infections. Predisposing factors include the chronic use of corticosteroids, organ transplantation and other immunocompromise conditions. Pleural empyema caused by this microorganism has scantily been reported. Read More

BMC Infect Dis 2021 May 31;21(1):509. Epub 2021 May 31.

Department of Laboratory Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Ave. E, Hamilton, Ontario, L8N 4A6, Canada.

Background: Readily-available diagnostics do not reliably discriminate between viral and bacterial pediatric uncomplicated pneumonia, both of which are common. Some have suggested that assessment of pneumococcal carriage could be used to identify those children with bacterial pneumonia. The objective of this study was to determine if nasopharyngeal pneumococcal colonization patterns differed between children with definite viral disease, definite bacterial disease, and respiratory disease of indeterminate etiology. Read More

Z Gerontol Geriatr 2021 May 31. Epub 2021 May 31.

Diagnostische und interventionelle Radiologie, Campus Duisburg, Helios Klinikum Duisburg, Duisburg, Deutschland.

J Cardiothorac Surg 2021 May 28;16(1):149. Epub 2021 May 28.

Department of Thoracic Surgery, First Hospital of Jilin University, Xinmin street 71, Chang Chun, 130021, People's Republic of China.

Background: To retrospectively assess the efficacy of hypertonic glucose pleurodesis for treatment of chylothorax after pulmonary resection.

Methods: Out of a total of 8252 patients who underwent pulmonary resection (at least lobectomy) at department of thoracic surgery, between June 2008 and December 2015, 58 patients (0.7%) developed postoperative chylothorax. Read More

Ann Palliat Med 2021 May 14;10(5):5046-5054. Epub 2021 May 14.

Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Background: Postoperative chronic empyema (PPE) remains a complex challenge for thoracic surgeons. We retrospectively investigated patients with PPE who were treated with free vastus lateralis muscle flap transplantation, and report our results.

Methods: Eight patients with PPE and persistent bronchopleural fistula (BPF) treated in our hospital from January 2015 to June 2019 were retrospectively analyzed, the time since onset of empyema ranged from 5 to 72 months. Read More

Surg Infect (Larchmt) 2021 May 26. Epub 2021 May 26.

Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

The role of negative pressure wound therapy (NPWT) in the management of open chest wounds is unclear. Our aim was to determine the safety and efficacy of NPWT compared with conventional therapy for open chest wounds. Ten patients with infected open chest wounds were included in a prospective trial of NPWT after surgical debridement. Read More

Interact Cardiovasc Thorac Surg 2021 May 26. Epub 2021 May 26.

Department of Thoracic Surgery, Ataturk University, School of Medicine, Erzurum, Turkey.

Objectives: This study investigated the effectiveness of the modified technique (Aydin Technique), which was applied for capitonnage in the surgical treatment of giant pulmonary hydatid cysts.

Methods: Twenty-two cases were operated on for giant hydatid cysts with a total of 23 modified techniques for capitonnage (bilateral giant hydatid cyst in 1 case) in our clinic between January 2018 and December 2020. The demographic data were recorded. Read More

BMJ Case Rep 2021 May 26;14(5). Epub 2021 May 26.

ENT & Head and neck surgery, All India Institute of Medical Sciences, New Delhi, India.

Sinogenic intracranial and orbital complications are infrequent complications of chronic rhinosinusitis with nasal polyposis (CRSwNP), leading to potentially fatal intracranial and orbital sequelae. The mortality and morbidity associated with these complications remain high despite the widespread use of antibiotics. We report a patient with CRSwNP presenting with acute onset extradural empyema and sixth nerve palsy in whom the diagnosis was delayed, necessitating early surgical intervention. Read More

World J Surg Oncol 2021 May 26;19(1):158. Epub 2021 May 26.

Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.

Background: Bronchopleural fistula (BPF) refers to an abnormal channel between the pleural space and the bronchial tree. It is a potentially fatal postoperative complication after pulmonary resection and a complex challenge for thoracic surgeons because many patients with BPF ultimately develop refractory empyema, which is difficult to manage and has a major impact on quality of life and survival. Therefore, an operative intervention combined with conservative and endoscopic therapies may be required to control infection completely, to occlude BPF, and to obliterate the empyema cavity during treatment periods. Read More

J Med Microbiol 2021 May;70(5)

Division of Infection, Barts Health NHS Trust, London, UK.

Pleural infections cause major morbidity and mortality, particularly amongst paediatric and elderly populations. The aetiology is broad, but pleural culture fails to yield a causative pathogen in approximately 40 % of cases. Alternative pathogen identification methods are therefore required. Read More

BMJ Case Rep 2021 May 25;14(5). Epub 2021 May 25.

Department of Internal Medicine, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.

A 44-year-old man presented to the emergency department with fever and right anterior chest pain. He reported a persistent cough and the development of sudden-onset right anterior chest pain after coughing. The inspiratory pain in the right lung was severe, and therefore deep breathing was impossible. Read More

BMJ Case Rep 2021 May 24;14(5). Epub 2021 May 24.

Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

A 34-year-old woman is admitted to the hospital with dyspnoea, dry cough and left-sided flank pain. Her urinary test was positive and CT imaging demonstrated multifocal pneumonia with pulmonary abscesses. Although she had initial clinical improvement on appropriate antibiotic therapy, her hospital course was complicated by worsening flank pain, hypoxemia and leucocytosis, prompting clinical re-evaluation and assessment for development of complications involving the pleural space. Read More

Chest 2021 May 20. Epub 2021 May 20.

Department of Pulmonary and Critical Care, Metro Health-University of Michigan Health, Wyoming, MI 49519.

Background: Comprehensive U.S. epidemiologic data for adult pleural disease are not available. Read More

Cureus 2021 Apr 17;13(4):e14534. Epub 2021 Apr 17.

Internal Medicine, Bhaskara Medical College, Hyderabad, IND.

The group (SAG) consists of three bacteria (, , and ) that are known commensals of the upper respiratory, digestive, and reproductive tracts. While a rare occurrence, these bacteria have the capability of causing devastating pyogenic infections and ensuing abscess formations. It is often difficult to distinguish this group as a contaminant or the offending organism (as it is often cultured in respiratory specimens); therefore, it is important to understand the risk factors, clinical presentation, and diagnostic findings that can provide a more accurate picture to identify the organism. Read More

Turk Arch Pediatr 2021 Jan 1;56(1):88-91. Epub 2021 Jan 1.

Department of Neurosurgery, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey.

can be frequently isolated from brain abscesses, but is a rare cause of the liver, lung, and deep tissue abscesses. In this report, we present a patient with subdural empyema, brain abscess, and superior sagittal cerebral venous thrombosis as complications of rhinosinusitis whose purulent empyema sample yielded . A 13-year-old female patient was referred to our pediatric intensive care unit with altered mental status, aphasia, and behavioral change. Read More

Case Rep Pediatr 2021 29;2021:6620353. Epub 2021 Apr 29.

Department of Pediatrics, Tohoku University Hospital, 1-1,Seiryo-Cho,Aoba-Ku, Sendai 980-8574, Japan.

Thoracic empyema usually occurs as a complication of bacterial pneumonia, but in rare cases, it is caused by hematogenous dissemination secondary to nonpulmonary diseases. Congenital chylothorax or chylothorax in children is associated with maldevelopment of the lymphatic system, nonimmune hydrops fetalis, several syndromes including Down syndrome, Noonan syndrome, or Turner syndrome, a complication of thoracic surgery, right heart failure with high central venous pressure, or tumors. There are very few reports of empyema associated with preexisting chylothorax. Read More

Caspian J Intern Med 2021 Mar;12(2):232-235

Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Peritoneal infection following pleural empyema is not a common occurrence. Concomitant pleural empyema and peritonitis have been described in the literature mostly in immunocompromised patients with different pathogenic mechanisms and a wide array of microorganisms. Here we report a case of concomitant pleural empyema and peritonitis with an unusual microorganism in an immunocompetent host. Read More

Indian J Pediatr 2021 May 19. Epub 2021 May 19.

Department of Pediatrics, Military Hospital Dehradun, Dehradun, Uttarakhand, India.

Gastropleural fistula (GPF) is a pathological communication between stomach and pleural cavity. GPF is described rarely in adults following bariatric surgery, iatrogenic perforations, complicated empyema thoracis, penetrating chest trauma, perforated malignant gastric ulcers, and invasive tumors. GPF in children is extremely rare. Read More

Vaccine 2021 Jun 15;39(26):3516-3519. Epub 2021 May 15.

Division of Pediatric Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Munich, Germany. Electronic address:

Background: Recently, emergence of a higher proportion of serotype 3 in children with parapneumonic pleural effusion/empyema (PPE/PE) were observed in Germany despite general immunization with 13-valent pneumococcal conjugate vaccine (PCV13) since 2009. The impact of PCV13 on the overall incidence of PPE/PE in children is unclear.

Methods: Annual incidence of PPE/PE in children were determined using secondary health care data for 2009-2018, provided by the Barmer statutory health insurer, serving about 11% of the German population. Read More

Diagn Interv Radiol 2021 May;27(3):401-407

Department of Radiology, Hacettepe University School of Medicine. Ankara, Turkey.

Purpose: We aimed to evaluate the results of percutaneous management of complicated parapneumonic effusions (PPE) and empyema after surgical tube thoracostomy failure in children.

Methods: A total of 84 children treated percutaneously after surgical tube thoracostomy failure between 2004 and 2019 were included to this retrospective study. Technical success was defined as appropriate placement of the drainage catheter. Read More