Empyema, Pleural Clinical Trial
Official title:
Retrospective Review on Patients With Culture Negative Empyema
Empyema is associated with a wide range of complication and mortality. It is defined by either a positive pleural fluid culture or grossly pus appearance. However, little is known about the differences in aetiology and outcome between culture-positive empyema (CPE) and culture-negative empyema (CNE). The aim of the current study is to look at the local prevalence of CNE, and compare the clinical outcome between CPE and CNE.
Pneumonia is a common disease and it ranked second as the leading cause of death in Hong Kong
in 2016. Among patients suffering from acute pneumonia, up to 57% of them would develop
parapneumonic effusion. Without proper treatment, parapneumonic effusion would progress into
empyema, which is a clinical emergency. Empyema leads to a longer length of hospital stay, a
higher rate of complication and mortality than uncomplicated parapneumonic effusion.
The mainstay of treatment for empyema is antibiotics and drainage. Therefore, identification
of causative microorganism is important in guiding the choice of antibiotics. The common
bacterial culprits, for community acquired and hospital acquired, were identified by various
local and international studies. However, the aetiological agents were still unknown in up to
40% of cases. In addition, the clinical outcomes between culture negative empyema (CNE) and
culture positive empyema (CPE) are largely unknown. Data from one Taiwanese study suggested
that patients with CPE had a higher in-hospital mortality than those with CNE. However, the
primary objective of this study was not putting on the importance of CNE. Therefore, data on
outcome of CNE patients remain largely uncertain, either worldwide and local population.
The aim of the current study is to look at the local prevalence of CNE, and compare the
clinical outcome between CPE and CNE. Through more understanding of CNE, the clinical
management of this patient group may be altered and a better patient outcome is anticipated.
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