Acute purulent pleurisy

Overview suppurative pleurisy (empyema) is one of the common diseases chest, pleural cavity is infected by the pathogen, the accumulation of abscess formation. According to the length of the course, divided into acute and chronic empyema empyema two categories. According to the different pathogenic bacteria, into suppurative, tuberculosis and other specific pathogen empyema. Under the pleural cavity involvement of limitations can be divided into (sexual cyst) empyema and the whole empyema. Pathology and pathogenesis of acute empyema was mainly due to the pleural cavity caused by secondary infections. Common reasons are the following : (1) pulmonary infection : About 50% of the empyema secondary acute inflammatory lesions in the lungs after. Directly lung abscess and pleural invasion or acute rupture of empyema. (2) adjacent pyogenic lesions : mediastinal abscess, or subphrenic abscess of liver abscess, lymphoid tissue by bacteria or direct broke through invasive pleural cavity can be formed with unilateral or bilateral pleural empyema. (3) chest surgery : after more with empyema bronchopleural fistula or esophageal anastomotic fistula merger. To a lesser extent due to pollution or during postoperative chest wound infection caused by penetration. (4) chest trauma : penetrating chest wound, because the shrapnel, clothing and other debris foreign body may be pathogens into the pleural cavity. Moreover, often hemothorax, easily forming suppurative infections. (5) sepsis or sepsis : menstruation cycle bacteria have arrived at the pleural empyema. this was particularly prevalent in infants or frail patients. Patients with clinical manifestations often chest pain, fever, shortness of breath, rapid pulse, the whole body discomfort, loss of appetite and other symptoms, such as pneumonia and acute empyema, pneumonia after more than a two-week chest pain, high fever of history. An inspection. Blood leukocyte count increased number of neutrophils. 2.X ray examination of pleural effusion due to the volume and location of different performance varied. 3. Ultrasound examination showed fluid wave reflection, a clear fluid scope and precise positioning, help determine puncture site. 4. Empyema diagnosed, must do influence the pleural puncture Pott. And for smear, culture and antibiotic sensitivity test, and so choose an effective antibiotic treatment. Treatment of acute treatment of empyema, including infection control, eliminate Pott, general support treatment in three aspects. (1) Infection Control : According to pathogens and susceptibility testing adequate and effective use of antimicrobials (Cefetaxime acridine, cefazolin V, ofloxacin, metronidazole), by intravenous administration for the good efficacy, safety, and the timely adjustment of drug and dosage. (2) exclude Pott : is the key to the treatment of empyema. Following the one-year-old infants can puncture the chest and inject antibiotic treatment, many will be satisfied with the results. Great age of the patients, early implementation thoracic drainage, Pai do Pott. Drainage after regular X-ray examination, at any time thoracic primer; Guarantee drainage and encourage patients to more Shimoji activities. (3) the treatment of systemic support : including high-protein, high-calorie, high-vitamin diet, encourage water. If necessary, intravenous rehydration and blood transfusion.