20 December 2021: Articles
Pleural Empyema as a Complication of Pyogenic Liver Abscess: Can the Minimum Achieve the Optimal? A Comparison of 3 Approaches
Rare coexistence of disease or pathology
Zeead M. AlGhamdi A* , Dhuha N. Boumarah A , Shadi Alshammary A , Hatem Elbawab ADOI: 10.12659/AJCR.935169
Am J Case Rep 2021; 22:e935169
Table 1. A brief summary of all pleural empyema cases developing secondary to liver abscess.
| Author(s (year) | Age/Sex | Clinical presentation | Comorbidities | Liver abscess microbial agent | Management of empyema (other than Abx) | Follow-up and outcomes |
|---|---|---|---|---|---|---|
| Valero et al (1985) | 28/M | Dyspnea and chest pain | CD | Chest tube drainage followed by surgical drainage | Complete resolution after 1 month | |
| Luthariana et al (2005) | 24/M | Abdominal pain, nausea, vomiting and anorexia after history of fever nd weight loss | None | Negative culture | Chest tube drainage | LOS was 1 month |
| Loulergue et al (2009) | 57/M | Chest pain, anorexia, watery diarrhea and weight loss | None | Pleural drainage for 10 days | Uneventful and no recurrence until 6 months | |
| Chang et al (2011) | 27/M | Dyspnea and abdominal pain | None | Entamoeba histolytica | Chest tube drainage | LOS was 1 month. No recurrence until 1 year |
| Sano et al (2015) | 64/M | Dyspnea and fever | None | Klebsiella pneumoniae | Chest tube drainage followed by thoracotomy for decortication and drainage | Uneventful |
| Ahmed et al (2015) | 21/M | Fever, abdominal pain, diarrhea and weight loss followed by respiratory distress | None | Fusobacterium | Chest tube drainage followed by VATS for partial decortication and drainage | Developed intra-abdominal abscesses managed with IV Ertapenem and complete resolution was achieved after 9 weeks of treatment |
| Pandhi et al (2017) | 20/M | Chest pain, abdominal pain, fever, dyspnea and cough | HIV | Chest tube drainage | Uneventful | |
| Nasrullah et al (2017) | 42/M | Dyspnea, fever, chest pain and cough | IHD and HTN | Chest tube drainage followed by VATS for decortication and drainage | The patient’s symptoms failed to resolve initially, necessitating laparotomy to drain the liver abscess | |
| Doh Kim (2018) | 47/M | Dyspnea, fever, chest pain, and abdominal pain | None | Percutaneous drainage through a pig-tail catheter | Symptoms improved after management, with no evidence of recurrence until 6 months | |
| Sheih et al (2018) | 49/F | Abdominal pain and fever | DM | Thoracentesis followed by VATS for decortication and drainage | LOS was 49 days | |
| Cho et al (2018) | 65/M | Dyspnea, fever and abdominal pain | None | Pigtail catheter drainage | Pt had also pericardial effusion, progressed, necessitating surgical pericardiostomy and was discharged 25 days of surgery | |
| Lee et al (2019) | 81/F | Dyspnea and fever | HTN | (pleural fluid only) | Chest tube drainage for 28 days | Improvement was observed after hepatic abscess drainage |
| Gohar et al (2019) | 54/M | Dyspnea, fever, chest pain, night sweats, weight loss and abdominal pain | Non | Fusobacterium | Chest tube drainage for 7 days | LOS was 7 days. No recurrence until weeks of follow-up |
| Yi et al (2019) | 10 out of 234 developed empyema (median age was 60.2±14.5) 4 of these cases were males | – | DM, HTN, CKD, heart disease and 1 pt was smoker | in 3 pts. Gram-positive organisms in 3 pts, mixed culture in 3 pts and 1 pt had a negative culture | Chest tube drainage in 5 pts, 5 pts required VATS for surgical decortication (3 patients underwent initial chest tube drainage, and 2 patients underwent initial VATS drainage without chest tube insertion) | Median LOS was 38.5±12.7 days |
| M – male; F – female; RUQ – right upper quadrant; Abx – antibiotics; LOS – length of stay; Pt – patient; IHD – ischemic heart disease; HTN – hypertension; IV – intravenous; VATS – video-assisted thoracoscopic surgery; CKD – chronic kidney disease; DM – diabetes mellitus; HIV – human immunodeficiency virus; CD – Crohn’s disease. | ||||||