Delayed postpneumonectomy empyema.
OBJECTIVE
Most postpneumonectomy empyemas occur shortly after the surgery, but rarely do they manifest much later. We present our experience in treating two cases of delayed postpneumonectomy empyema and discuss its clinical features.


METHODS
The diagnosis of delayed empyema is difficult as patients present with nonspecific symptoms. Consequently, there was a delay of several weeks in reaching the correct diagnosis. This is a retrospective case study of two patients.


METHODS
The patients were admitted to hospital for appropriate care.


METHODS
Two patients were diagnosed as having delayed postpneumonectomy empyema from consequential infection. Chest X-ray may provide helpful information such as the presence of air-fluid level or a mediastinal shift toward the remaining lung (by accumulation of pus in the postpneumonectomy cavity).


METHODS
The patients were treated surgically.


RESULTS
In both cases the diagnosis of postpneumonectomy empyema was delayed, but eventually correct diagnosis was made. The outcome of the surgical therapy was successful.


CONCLUSIONS
Delayed postpneumonectomy empyema is a rare condition. The etiology in the majority of cases is probably due to hematogenous spread of bacteria from other parts of the body. Correct diagnosis of this condition is often delayed. The treatment is surgical.
School of Medicine, State University of New York at Buffalo, USA.
O J
OJ
Schueckler
M I
MI
Rodriguez
H
H
Takita
D016724:Empyema, Pleural / Q000209:etiology*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D013997:Time Factors