bobby
Forum Guru
Topics: 136
Posts: 569
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mcc of empyema
S. aureus
S. pyogenes
E. coli
S. pneumoniae
p. aeruginosa
i have got different ans for this question from different sources.
what do u think is the correct ans?
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| oddissy4u
Forum Guru
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staph aureus :!:
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| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
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if G- E. Coli if G+ Staph. Bust more common cause of pneumonia is Staph, so I d go with Staph
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| bobby
Forum Guru
Topics: 136
Posts: 569
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the ans given is S. pneumoniae.
i have doubt about this
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| Idiopathic
Forum Guru
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My argument would be that Streptococcus causes more pneumonia, far and away, than anything else. Ruling out chest trauma and using what is there (i.e. no Bacteroides for aspiration), I would have to pick S. pneumoniae
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| Idiopathic
Forum Guru
Topics: 19
Posts: 641
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interesting:
"template for a typical chapter
empyema
/incidence & epidemiology
Empyema is the presence of gross pus in the pleural cavity; it consists of an effusion containing polymorphonuclear leukocytes and fibrin. The Greek philosopher, Aristotle, recognized empyema and described the drainage of pus with incision and a metal tube as early as 300 BC. A parapneumonic process is defined as a pleural effusion associated with pneumonia, lung abscess or bronchiectasis. Not all parapneumonic processes are empyemas.
anatomy & physiology
The pleural space is actually a potential space created by the visceral and parietal pleura. It normally contains a scant amount of fluid which facilitates movement of the lung with the diaphragm and chest wall. Several mechanisms contribute to the development of an effusion. Pleural fluid can accumulate when alterations in hydrostatic and oncotic pressure accompany cardiac, renal, hepatic or metabolic disease, or when there are changes in pleural fluid permeability secondary to inflammation, infection, toxin, malignancy or trauma. Common provocations that increase permeability include:
congestive heart failure (increased capillary hydrostatic pressure)
nephrotic syndrome (decreased plasma oncotic pressure)
post thoracentesis (decreased hydrostatic pressure of the pleural space), and
malignancy (impaired lymphatic drainage).
A pleural effusion provides a rich culture medium in which white blood cell defenses can be impaired and an empyema may flourish.
stages in the development of an empyema
By convention, the formation of an empyema can be divided into three phases: exudative, fibrinopurulent and organizing. During the first or exudative phase, pus accumulates. This is followed by fibrin deposition and loculation of pleural fluid known as the fibrinopurulent phase. The last phase, the organizing phase, is characterized by fibroblast proliferation; at this time there is the potential for lung entrapment by scarring.
incidence & epidemiology
Pleural effusions are most common in children with pneumonia. However, empyema is a rare complication of pneumonia. The reported incidence of empyema following pneumonia varies (0.7% to 9%) in the pediatric literature. A recent review of 50 cases of pediatric empyema reported that the incidence of empyema is increasing and the epidemiology is changing. In the 1940's, before the development of penicillin and sulfa antibiotics, empyema was usually caused by Streptococcus pneumonia. Over the next two decades, Staphylococcus aureus bacteria was reported as the most frequently cultured organism from empyema fluid until the discovery of penicillinase resistant penicillins.
In the 1980's Haemophilus influenza type b caused a majority of pediatric empyema but with the development of the H. flu vaccine, Streptococcus pneumonia has again taken the lead as the most frequent pathogen cultured from empyema fluid in children. The age of patients presenting with empyema is also changing. Twenty years ago, the average child with empyema was less than 2 years old and recently the median age was reported as 7 years. Empyema still affects both males and females equally and has a seasonal distribution, occurring more frequently in the winter and spring."
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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bobby,
Strep pneumoniae is correct ,apart from that the second choice would be kleb pneumoniae .
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| elsa
Forum Junior
Topics: 5
Posts: 46
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thanks idiopathic for your nice discussion about empyema.
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elsa
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| elsa
Forum Junior
Topics: 5
Posts: 46
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In addition to idiopathic discussion Empyema is an accumulation of pus in the pleural spaces and usually associated to pneumonia cause by strep pneumoniae. S. aureus can also caused empyema and it is most common in developing countries and in post traumatic empyema. H. influenzae can also cause empyema as just what idiopathic told us due to the development of Hib vaccine it incidence decreased. It is also nice to know other microorganism and conditions that less likely to cause empyema this are Group A strep. gm negative org, TB,fungi and malignancy
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elsa
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