Empyema thoracis is most commonly caused by which organism-
Ans. is 'a' i.e., Streptococcus pneumonia o Empyema Thoracis is defined as collection of Pus in the pleural space,o It is actually parapneumonic effusion stages 3.o Parapneumonic effusions are pleural effusions that occur in the pleural space adjacent to a bacterial pneumonia.o They occur in at least 40 percent of bacterial pneumonias.o The usual parapneumonic effusion is small and resolves with appropriate antibiotic therapy.o However, if bacteria invade the pleural space, a complicated parapneumonic effusion or empyema may result, which will necessitate antibiotic therapy plus additional interventions.Parapneumonic pleural effusions are divided into three croups or stages based upon pathogenesis : -UR complicated parapneumonic effusiono An uncomplicated effusion occurs when lung interstitial fluid increases during pneumonia and moves across the adjacent visceral pleural membrane.o The pleural fluid is characterized by "exudative" chemistries and an influx of neutrophils into the pleural space.o Uncomplicated pleural effusions form when the resorptive capacity of the pleural space is exceeded; they resolve with resolution of the pneumonia.o Among patients with bacieremic pneumococcal pneumonia, pleural effusions are common and are usually sterile.Complicated parapneumonic effusiono Complicated effusions occur when there is persistent bacterial invasion of the pleural space,o Bacterial invasion typically leads to an increased number of neutrophils and the development ofpleural fluid acidosis, which results from anaerobic utilization of glucose by the neutrophils and bacteria.o In addition, lysis of neutrophils increases the LDH concentration in the pleural fluid to values often in excess oflOOOIU/L.o Because bacteria can be cleared rapidly from the pleural space, cultures of fluid from complicated parapneumonic effusions are generally negative.a This occurs despite the deposition of a dense layer offibrin on both the visceral and parietal pleurae that can lead to pleural loculation.Thoracic empyemao Formation of empyema is the third stage and is characterized by bacterial organisms seen on Gram stain and/ or the aspiration of pus on thoracentesis.o Epyema thoracic is commonly caused by those bacterias that cause pneumonias such as streptococcus pneumoniae and staphlococcus aureus. E.coli, H. in fluenzas, Klebsiella pneumoniae.
Streptococcus pneumoniae
Pseudomonas
Mycoplasma
Stapylococcus aureus
Pneumonia, Bronchiectasis, and Lung Abscess