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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 A

DOI: 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/SexClinical presentationComorbiditiesLiver abscess microbial agentManagement of empyema (other than Abx)Follow-up and outcomes
Valero et al (1985)28/MDyspnea and chest painCDChest tube drainage followed by surgical drainageComplete resolution after 1 month
Luthariana et al (2005)24/MAbdominal pain, nausea, vomiting and anorexia after history of fever nd weight lossNoneNegative cultureChest tube drainageLOS was 1 month
Loulergue et al (2009)57/MChest pain, anorexia, watery diarrhea and weight lossNonePleural drainage for 10 daysUneventful and no recurrence until 6 months
Chang et al (2011)27/MDyspnea and abdominal painNoneEntamoeba histolyticaChest tube drainageLOS was 1 month. No recurrence until 1 year
Sano et al (2015)64/MDyspnea and feverNoneKlebsiella pneumoniaeChest tube drainage followed by thoracotomy for decortication and drainageUneventful
Ahmed et al (2015)21/MFever, abdominal pain, diarrhea and weight loss followed by respiratory distressNoneFusobacteriumChest tube drainage followed by VATS for partial decortication and drainageDeveloped intra-abdominal abscesses managed with IV Ertapenem and complete resolution was achieved after 9 weeks of treatment
Pandhi et al (2017)20/MChest pain, abdominal pain, fever, dyspnea and coughHIVChest tube drainageUneventful
Nasrullah et al (2017)42/MDyspnea, fever, chest pain and coughIHD and HTNChest tube drainage followed by VATS for decortication and drainageThe patient’s symptoms failed to resolve initially, necessitating laparotomy to drain the liver abscess
Doh Kim (2018)47/MDyspnea, fever, chest pain, and abdominal painNonePercutaneous drainage through a pig-tail catheterSymptoms improved after management, with no evidence of recurrence until 6 months
Sheih et al (2018)49/FAbdominal pain and feverDMThoracentesis followed by VATS for decortication and drainageLOS was 49 days
Cho et al (2018)65/MDyspnea, fever and abdominal painNonePigtail catheter drainagePt had also pericardial effusion, progressed, necessitating surgical pericardiostomy and was discharged 25 days of surgery
Lee et al (2019)81/FDyspnea and feverHTN(pleural fluid only)Chest tube drainage for 28 daysImprovement was observed after hepatic abscess drainage
Gohar et al (2019)54/MDyspnea, fever, chest pain, night sweats, weight loss and abdominal painNonFusobacteriumChest tube drainage for 7 daysLOS 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 malesDM, HTN, CKD, heart disease and 1 pt was smokerin 3 pts. Gram-positive organisms in 3 pts, mixed culture in 3 pts and 1 pt had a negative cultureChest 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.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923