title: The clinical utility of intrapleural streptokinase in a patient with bilateral pleural empyema.
abstract: Bilateral thoracic empyema is a rare clinical entity particularly when presented as an initial clinical manifestation. Antibiotic therapy with intercostal thoracostomy drainage tube of the infected pleural space in complicated parapneumonic empyema may not be adequate in many conditions due to multiloculation and adhesion. We describe in this case a previously healthy middle aged male, presented with a bilateral thoracic empyema that was treated initially with antibiotics and intercostal drainage tube without optimal drainage results. The administration of twice daily intrapleural streptokinase prolonged for the duration of more than 10 days proved to be safe and effective as an alternative line of management in such a clinical condition.
authors.affiliation: Department of Medicine, King Fahd Military Medical Complex, Dhahran, Kingdom of Saudi Arabia.
authors.forename: Nayef A
authors.initials: NA
authors.lastname: Al-Ahmadi
authors.forename: Taysir S
authors.initials: TS
authors.lastname: Garadah
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Nwasser
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D004322:Drainage / Q000379:methods; D004333:Drug Administration Routes; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D013902:Radiography, Thoracic; D013290:Streptococcal Infections / Q000150:complications / Q000628:therapy; D013291:Streptococcus / Q000302:isolation & purification; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D013909:Thorax / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D013300:Streptokinase