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Chin Med J (Engl) 2018 Dec;131(24):2989-2990

Department of Neurology, The Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China.

Respirology 2018 Dec 11. Epub 2018 Dec 11.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Breathe (Sheff) 2018 Dec;14(4):302-310

Clinic for Thoracic Surgery, University Hospital Basel, Basel, Switzerland.

The widely accepted and still increasing use of video-assisted thoracic surgery (VATS) in pleuro-pulmonary pathology imposes the need to deal with two major pitfalls: the first is to avoid its unselective use, while the second relates to inappropriate rejection of VATS on the basis of "insufficient radicality". Unlike a quite established role of VATS in lung cancer patients, in patients with pleural empyema, the role of VATS is less clearly defined. The current evidence about VATS in patients with pleural empyema could be summarised as follows: VATS is accepted as a useful treatment option for fibrinopurulent empyema, but the treatment failure rate increases with the increasing proportion of stage III empyema, necessitating further surgical options like thoracotomy and decortication. Read More

Respir Med Case Rep 2019 12;26:35-38. Epub 2018 Nov 12.

Department of Tuberculosis, Wuhan Jinyintan Hospital, NO.1 Yintan Road, Dongxihu District, Wuhan 430023, Hubei, China.

Background: Anhydrous ethanol, for its part, has been successfully used to treat renal cyst, hepatocellular carcinoma and ovarian chocolate cyst et al. However, in spite of the high frequency of tuberculous purulent pleural effusion, we found that only a few very early studies that attempted to assess the use of intrapleural anhydrous ethanol in tuberculous effusions with signs of empyema. We report a patient who was injected anhydrous ethanol into pleural cavity to treat chronic tuberculous empyema. Read More

J Thorac Dis 2018 Nov;10(Suppl 32):S3781-S3788

Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.

Surgical resection of lung cancer is the preferred treatment for early-stage disease in medically fit patients. The rates of postoperative pulmonary complications (PPCs) such as pneumonia, empyema and atelectasis are as high as 10% in contemporary series. A review of the literature was performed to identify the best evidence supporting interventions to identify, prevent and treat PPCs. Read More

J Thorac Dis 2018 Nov;10(Suppl 32):S3728-S3739

Division of Thoracic Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Prolonged alveolar air leak (PAL) is the most common adverse event following pulmonary resection. It carries morbidity for patients by increasing empyema risk, and for hospital administration with the cost of prolonged length of hospital stay (LOS). Intra-operative sealant technology is available to surgeons, and may decrease PAL. Read More

J Thorac Dis 2018 Nov;10(Suppl 31):S3696-S3703

Competence Center of Thoracic Surgery, Department of Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background: The efficacy of video-assisted thoracic surgery (VATS) in the treatment of pleural empyema has recently been proven. Till today, very few works evaluated the role of uniportal-VATS (U-VATS) approach in the treatment of pleural empyema even if it currently represents the most innovative and less invasive thoracoscopic approach. We report our experience with U-VATS in the treatment of pleural empyema. Read More

J Thorac Dis 2018 Nov;10(Suppl 31):S3678-S3685

Department of General Thoracic Surgery, Catholic University of Sacred Heart, Fondazione Policlinico Universitario "A.Gemelli", Rome, Italy.

Background: The acceptance of uniportal video-assisted thoracic surgery (U-VATS) for thoracic procedures has been growing worldwide. This study reports one of the widest Italian U-VATS experiences.

Methods: The prospectively collected data of 237 patients underwent a U-VATS procedure, between May 2016 and September 2017, were retrospectively reviewed. Read More

J Thorac Dis 2018 Oct;10(Suppl 28):S3408-S3418

Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA.

The role of thoracic surgeons in the management of pulmonary infection has evolved over time as the medical treatments have improved. We herein review historical and current management for surgically-treated pulmonary infections-lung abscesses, empyemas, and bronchopleural fistulas. In particular, we review when the surgeons need to be involved for infectious cases, our algorithm/approach to empyemas, and summary of post-operative bronchopleural fistula in tuberculosis cases. Read More

J Thorac Cardiovasc Surg 2018 Nov 10. Epub 2018 Nov 10.

Division of General Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn. Electronic address:

BMC Pediatr 2018 Dec 4;18(1):382. Epub 2018 Dec 4.

Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Nanlishi Road 56, Xicheng District, Beijing, People's Republic of China.

Background: Mediastinal teratoma is uncommon in children. It can be very difficult to diagnose especially in early stage. Rarely, teratoma may rupture into adjacent structures and lead to lung lesions or pleuritis. Read More

World J Clin Cases 2018 Nov;6(14):825-829

Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.

The prevalence of nasopharyngeal carcinoma (NPC) is higher in southern China, Hong Kong, and Taiwan than in other areas in the world. Radiotherapy is an important part of treatment for NPC patients, especially those with stage III/IV disease. Subdural empyema is a rare but life-threatening complication in postradiotherapy NPC patients which should be paid more attention. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13422

Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University.

Rationale: Most of esophageal rupture is a very serious life-threatening benign gastrointestinal tract disease with high mortality. However, there are a few cases of spontaneous esophageal rupture during gastroscopy.

Patient Concerns: A 57-year-old man who underwent a routine diagnostic gastroscopy due to food obstruction was reported. Read More

Mymensingh Med J 2018 Oct;27(4):898-903

Dr Shameem Ahmed, Senior Consultant Neurosurgeon, Department of Neurosurgery, Apollo Hospitals (Unit: International Hospital), Guwahati , India.

Staphylococcus aureus is a global bacterial pathogen. It is an uncommon pathogen causing central nervous system infections, accounting for <1% cases of bacterial meningitis. Sinusitis, trauma and presence of an intracranial device have been reported as risk factors for developing meningitis and brain abscesses. Read More

BMC Pulm Med 2018 Nov 29;18(1):179. Epub 2018 Nov 29.

Department of Thoracic Surgery, Combined Military Hospital, Peshawar, Pakistan.

Background: The treatment of early pleural empyema depends on the treatment of ongoing infection by antimicrobial therapy along with thoracocentesis. In complicated empyema this treatment does not work and lung will not expand until removal of adhesions. The objective of the current study is to analyze the experience of management of multiloculated, exudative and fibrinopurulent empyema through rigid medical thoracoscopy under local anaesthesia and to explore new ways to manage the entity. Read More

Urol Int 2018 Nov 28:1-5. Epub 2018 Nov 28.

Department of Obstetrics and Gynecology, Division of Urogynecology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

Sacrocolpopexy is the gold standard treatment for apical compartment prolapse with reported success rates of 78-100%. Spondylodiscitis is a rare complication of sacrocolpopexy and includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. Here we report a case of spondylodiscitis following laparoscopic sacrocolpopexy with long-term follow-up and discuss management of spondylodiscitis after abdominal sacrocolpopexy, with a review of the literature. Read More

Case Rep Gastroenterol 2018 Sep-Dec;12(3):633-639. Epub 2018 Oct 24.

Division of Gastroenterology and Hepatology, St. Joseph's University Hospital Paterson, Paterson, New Jersey, USA.

Extraintestinal infection (CDI) is extremely uncommon. High mortality and poor outcomes have been observed among individuals with this rare medical condition. Empyema is one of the extraintestinal manifestations of CDI. Read More

Gastrointest Endosc 2018 Nov 24. Epub 2018 Nov 24.

Department of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama-city, Toyama 930-8550, Japan.

Multimed Man Cardiothorac Surg 2018 Nov 21;2018. Epub 2018 Nov 21.

Cardiothoracic Surgery Department Assiut University Heart Hospital Assiut University, Faculty of Medicine Assiut, Egypt.

The uniportal VATS approach is now taking the lead in the practice of thoracic surgery and is transforming the way we operate. We describe here how to perform a uniportal VATS debridement and decortication, with a special focus on tips and tricks for getting inside an empyema pouch and identifying the optimal plane of cleavage for decortication. Read More

BMC Pulm Med 2018 Nov 23;18(1):176. Epub 2018 Nov 23.

Department of Internal Medicine, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.

Background: We aimed to determine the presepsin concentration in pleural fluid from patients with pleural effusions of different aetiologies and to compare its diagnostic value with that of pleural fluid C-reactive protein (CRP) and procalcitonin (PCT).

Methods: We enrolled 132 patients with pleural effusion who underwent diagnostic evaluation, and we classified them into six categories: empyema, parapneumonic effusion, tuberculous effusion, malignant effusion, paramalignant effusion, and transudate effusion. Additionally, all pleural effusions were categorised as infectious or non-infectious effusions. Read More

Am J Med Sci 2018 Oct 16. Epub 2018 Oct 16.

Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, No.2, Zhongzheng 1st Road, Lingya District, Kaohsiung city 80284, Taiwan, ROC. Electronic address:

Phytomedicine 2018 Dec 20;51:112-119. Epub 2018 Jun 20.

Department of Applied Biological Chemistry, Graduate School of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan. Electronic address:

Background: Epimagnolin A is an ingredient of the Chinese crude drug Shin-i, derived from the dried flower buds of Magnolia fargesii and Magnolia flos, which has been traditionally used for the treatment of allergic rhinitis and nasal congestion, empyema, and sinusitis. The pharmacokinetic activity of epimagnolin A remains to be evaluated.

Purpose: In this study, we examined the possible interactions of epimagnolin A with human ATP-binding cassette (ABC) transporter ABCB1, a membrane protein vital in regulating the pharmacokinetics of drugs and xenobiotics. Read More

Medicine (Baltimore) 2018 Nov;97(47):e13291

Department of Pathology, Weihai Municipal Hospital, Weihai, Shandong, China.

Rationale: Primary diffuse large B-cell lymphoma of the chest wall is extremely rare. A majority of the pleural lymphomas develop in patients with chronic tuberculous pyothorax. The underlying mechanism might be attributed to the sustained stimulation of chronic inflammation. Read More

Clin Case Rep 2018 Nov 25;6(11):2144-2146. Epub 2018 Sep 25.

Thoracic Surgery Division Department of Surgery College of Medicine King Fahad Hospital of the University Imam Abdulrahman Bin Faisal University Al-Khobar, Dammam Saudi Arabia.

The use of U-VATS should be preferred to conventional three-port VATS if skills are mastered as it causes less and single intercostal trauma. Moreover, it minimizes infection spread to the chest wall. We advocate the use of U-VATS as a routine approach in patient with empyema stage III for positive outcome. Read More

Am Surg 2018 Apr;84(4):e150-e152

Department of General Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.

Br J Neurosurg 2018 Nov 19:1-3. Epub 2018 Nov 19.

a Departments of Paediatric Neurosurgery , Queen's Medical Centre , Nottingham , UK.

Lawsonella clevelandensis is a recently described species and genus of bacterium in the Corynebacterineae suborder which is Gram-stain positive, partially acid-fast and anaerobic. Very few cases of human infection due to this organism are described and here we seek to add to the limited medical literature. We report the case of a 2-year-old girl who presented with an infected spinal dermoid cyst secondary to Lawsonella clevelandensis which required surgical drainage and a long course of antibiotics. Read More

Childs Nerv Syst 2018 Nov 16. Epub 2018 Nov 16.

Division of Pediatric Neurosurgery, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Introduction: Subdural empyema (SDE) is a neurosurgical emergency that is typically treated with surgical drainage, either by burr hole or by craniotomy. Escherichia coli is an uncommon cause of SDE and is associated with infection of a pre-existing subdural hematoma.

Case Report: We report the case of an otherwise healthy, immunocompetent 4-month-old infant girl with an E. Read More

Rozhl Chir 2018 ;97(6):279-285

Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%. Read More

Rozhl Chir 2018 ;97(8):379-383

Introduction: Retrospective analysis of a group of patients treated for pleural empyema in the Department of Surgery, University Hospital Pilsen, over the last ten years.

Method: We evaluated a group of patients treated for pleural empyema in the Department of Surgery, University Hospital in Pilsen, during the period 2007-2016. We focused on the demographic data of this group, the causes of empyema in these patients, surgical procedures performed in connection with empyema, the microbial species found in empyema, and, last but not least, on morbidity and lethality. Read More

J Thorac Dis 2018 Sep;10(Suppl 26):S3271-S3273

Division of Cardiothoracic Surgery, University of Kentucky, Lexington, KY, USA.

J Thorac Dis 2018 Sep;10(9):5576-5583

Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.

Bronchial rupture by blunt chest trauma is rare. We present a case of bronchial injury after blunt chest trauma that was repaired surgically by primary reconstruction. We performed a review of literature to verify if primary reconstruction is suitable for the treatment of adult patients with blunt bronchial injury. Read More

J Thorac Dis 2018 Sep;10(9):5421-5427

Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.

Background: Surgery plays an important role in the management of complex thoracic infections (CTIs). We aimed to describe the contemporary surgical outcomes of CTIs.

Methods: The 2014-2017 National Surgical Quality Improvement Program (NSQIP) database was queried for patients with the following procedures: bilobectomy, decortication, lung release, lobectomy, thoracoscopic lobectomy, thoracoscopic pleurodesis, thoracoscopic wedge resection, thoracoscopic biopsy, thoracoscopy, thoracotomy, thoracotomy with wedge resection, thoracotomy with decortication, and thoracotomy with lobectomy. Read More

BMJ Case Rep 2018 Nov 8;2018. Epub 2018 Nov 8.

Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK.

A 70-year-old woman with lung metastases from a breast cancer presented with worsening cough and dyspnoea. She recently had a pleurodesis for a malignant pleural effusion. Chest CT scans demonstrated various radiological changes leading to diagnostic challenges. Read More

Am J Emerg Med 2018 Oct 26. Epub 2018 Oct 26.

University of South Florida, Lehigh Valley Medical Center, Allentown, PA 18103, United States of America.

Thoracostomy tube placement is one of the more common procedures performed in the Emergency Department, most commonly for treatment of pneumothorax or hemothorax but occasionally for drainage of empyema or pleural effusion. Thoracostomy may be a life-saving procedure with a wide range of complication rates reported, ranging from 19.4-37%, most commonly extrathoracic placement. Read More

Cureus 2018 Aug 29;10(8):e3227. Epub 2018 Aug 29.

Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, USA.

empyema is a rare complication of pneumonia. We report the case of a 67-year-old asplenic man with pneumonia complicated by respiratory failure and empyema requiring decortication and prolonged chest tube drainage. Cultures of the empyema were initially negative, but later grew vancomycin-resistant (VRE), which was successfully treated with linezolid. Read More

J Pediatric Infect Dis Soc 2018 Nov 8. Epub 2018 Nov 8.

Université Paris Est, IMRB-GRC GEMINI, Créteil, France.

We describe here changes in the bacterial causes of pleural empyema before and after implementation of the 13-valent pneumococcal conjugate vaccine (PCV13) program in France (2009-2017). For 220 (39.3%) of 560 children, a bacterial cause was found. Read More

Case Rep Infect Dis 2018 11;2018:7831284. Epub 2018 Oct 11.

Department of Medicine, Chief of Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, USA.

is a coagulase-negative organism, mainly an animal pathogen. Reports of human infection have been infrequent, mainly in patients with repeated animal contact. We report the first case of pleural empyema in an elderly woman. Read More

Front Neurol 2018 24;9:903. Epub 2018 Oct 24.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

We aimed to evaluate the occurrence, treatment, and outcomes of neurological complications after bacterial meningitis in young infants. A case series study from a retrospective cohort from two tertiary-level medical centers in Taiwan between 2007 and 2016 was conducted. Eighty-five young infants aged < 90 days with bacterial meningitis were identified. Read More

Clin Microbiol Infect 2018 Nov 3. Epub 2018 Nov 3.

Department of Paediatrics, University Hospital of Würzburg, Würzburg, Germany.

Objectives: Parapneumonic pleural effusions/empyema (PPE/PE) are severe complications of community-acquired pneumonia. We investigated the bacterial aetiology and incidence of paediatric PPE/PE in Germany after the introduction of universal pneumococcal conjugate vaccine (PCV) immunization for infants.

Methods: Children <18 years of age hospitalized with pneumonia-associated PPE/PE necessitating pleural drainage or persisting >7 days were reported to the German Surveillance Unit for Rare Diseases in Childhood between October 2010 and June 2017. Read More

Panminerva Med 2018 Oct 31. Epub 2018 Oct 31.

Divisione di Pneumologia, Spedali Civili di Brescia, Brescia, Italy.

Diseases of the pleura and pleural space are common and present a significant contribution to the workload of respiratory physicians, accounting for an annual incidence of more than 1.5 million cases in the US with the majority of cases resulting from congestive heart failure, pneumonia, and cancer 1. Although the radiographic and ultrasonographic detection of pleural abnormalities may be obvious, the determination of a specific diagnosis can often represent a challenge. Read More

Infect Disord Drug Targets 2018 Nov 4. Epub 2018 Nov 4.

Texas Tech University Health Sciences Center and Center for Infectious Diseases and Travel Medicine+, New Mexico State University. United States.

Salmonella enterica subspecies arizonae is a rare pathogen but has been reported in the literature in immunosuppressed and rarely immunocompetent patients. Most disease states have been reported in animals and reptiles. Human exposure has resulted in a range of complications from skin and soft tissue infections to bacteremia and periprosthetic joint infections. Read More

J Small Anim Pract 2018 Nov 2. Epub 2018 Nov 2.

CityU Peace Avenue Veterinary Clinic, Hong Kong, China.

This case series reviews previous publications and reports four feline spinal epidural empyema cases that presented with non-ambulatory thoracolumbar myelopathy. Two cats underwent myelography and two MRI. Bacteria were obtained in three cases, in two from epidural abscesses and from a tail base wound in one; histopathological examination of epidural tissue showed pyogranulomatous changes in the remaining cat. Read More

Respir Med Case Rep 2018 16;25:311-313. Epub 2018 Oct 16.

Department of pulmonary and critical care, Northwell health, Staten Island University Hospital, USA.

, a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR /denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR and . A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. Read More

Respirol Case Rep 2018 Dec 25;6(9):e00376. Epub 2018 Oct 25.

Department of Hepatogastroenterology Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan.

For hepatocellular carcinomas, radiofrequency ablation is extensively used to alleviate primary and metastatic hepatic tumours. Common complications of this procedure include bleeding, infection, and hollow organ perforation. We present the case of a patient with hepatoma who underwent radiofrequency ablation. Read More

N Engl J Med 2018 Nov;379(18):1767-1773

From the Departments of Medicine (N.S.D., C.J.M., B.D.L., J.L.) and Pathology (H.G.R.), Brigham and Women's Hospital and Harvard Medical School - both in Boston.

Gen Thorac Cardiovasc Surg 2018 Oct 29. Epub 2018 Oct 29.

Unit of Thoracic Surgery, Evangelismos Hospital, Athens, Greece.

Objective: We reviewed the available literature on patients with MPM undergoing either extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D).

Methods: Original research studies that evaluated long-term outcomes of P/D versus EPP were identified, from January 1990 to July 2018. The 30 and 90 days mortality, along with the 1-, 2-, 3-, 5-year survival, the median overall survival and the complications were calculated according to both a fixed and a random effect model. Read More

Scott Med J 2018 Oct 29:36933018807653. Epub 2018 Oct 29.

5 Consultant General Surgeon, Department of General Surgery, Forth Valley Royal Hospital, UK.

Introduction: Dropped gallstones are gallstones lost in the abdominal cavity during cholecystectomy. They are a rare occurrence and often cause minimal long-term issues. However, it is recognised that dropped stones can cause intra- or extra-abdominal sepsis. Read More

J Thorac Dis 2018 Sep;10(Suppl 26):S3069-S3070

Division of Cardiothoracic Surgery, University of Kentucky College of Medicine, Lexington, Kentucky, USA.

Int J Pediatr Otorhinolaryngol 2018 Dec 18;115:45-48. Epub 2018 Sep 18.

Department of ENT and Head and Neck Surgery, University Hospital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, University of Montpellier, France. Electronic address:

Intracranial empyema is a rare but serious complication of sinusitis in children. Myelodysplastic/myeloproliferative syndromes (MMS), including juvenile myelomonocytic leukemia (JMML), can lead to immunosuppression, thus favouring infections. We report the case of a sphenoid sinogenic retro-clival extradural empyema in a 14-year-old female patient associated with JMML. Read More