zaidsuror
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What is the most common cause of empyma?
someone said it is the anaerobe m.o!!!is that turue?
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| bactitech
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http://respiratory-lung.health-cares.net/empyema-...
http://www.emedicine.com/EMERG/topic463.htm According to this article:
"Synonyms and related keywords: aspiration, lung abscess, pleural pus, penetrating chest trauma, esophageal rupture, inoculation of the pleural cavity, thoracentesis, chest tube placement, subdiaphragmatic abscess, paravertebral abscess, poor dentition, absent gag reflex, septic emboli, vasculitic disorders, cavitating lung malignancies, pulmonary cystic disease, needle compression, polymicrobial oral flora, Bacteroides species, Fusobacterium species, Peptostreptococcus species, Staphylococcus aureus, S aureus, MRSA, Mycobacterium tuberculosis, M tuberculosis, skin flora, Staphylococcus epidermis, S epidermis, pleural effusion..."
As you can see, some are anaerobes, and some are not. The first three organisms are anaerobes. A sputum specimen will NOT be cultured for anaerobes. Actual aspirate from a lung abscess must be sent to the laboratory for culture for anaerobes, ideally in a syringe (minus the needle, of course, with a cap on the end) or an aspirate in a cup. DON'T send a swab, or shoot the aspirate into a culturette with the swab! This is just dumb and will be tsk'd tsk'd over by the micro department. ASPIRATES ARE ALWAYS BETTER!!!! If there is gobs of pus, please don't send the lab a tiny bit and ask for all kinds of cultures. Send us enough, please. I know I ride you guys a lot, but I'm trying to implant good form into your heads so that when you become residents, you will impress your chief resident and/or your attending.  If you require coverage for a specific organisms, i.e. Nocardia, TELL THE LAB ON THE REQUISITION AHEAD OF TIME so that they can add extra media to cover for these organisms.
I'll get off my soapbox now and go to bed - it's been a long day.
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| zaidsuror
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thanks alot
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