Empyema Thoracis In Kenyatta National Hospital

Abstract

This is a combined prospective and retrospective review 'study of empyema thoracis. Twenty patients admitted to Kenyatta National Hospital wards between November, 1980 and April 1981 were studied prospectively. Seventy nine patients admitted between January 1975 and October 1980 were studied retrospectively. Both groups have been reviewed to highlight various aspects of this disease, particularly its potentially crippling effect on the respiratory system and the fact that this is a preventable situation which is not yet fully appreciated in our country. Pulmonary disease was the most prevalent underlying aetiology in this series. Mycobacteria and Staph. Aureus were the most frequent causative organism followed by various gram negative bacteria. Culture was negative in 21% of all cases reviewed. The tendency of children under 10 years of age to have staphylococcal and multibacterial infection was noted. The ever increasing pneumonectomy rate on the background of inadequate initial. treatment coupled with scarcity of surgical beds and theatre time is highlighted. Finally paediatric age and presence of underlying disea were shown to have positive relationship with increased mortality, while traumatic and tuberculous aetiologies were found to have a higher risk of eventual pneumonectomy.