CLINICAL OUTCOMES AND CHARACTERISTICS IN PATIENTS WITH PLEURAL EMPYEMA: A RETROSPECTIVE STUDY FROM JINNAH HOSPITAL, LAHORE

Abstract

Background: Pleural empyema, the accumulation of pus in the pleural cavity, is a serious complication of pneumonia and other pulmonary conditions. It is associated with significant morbidity and requires early diagnosis and prompt management. Regional studies are important to define the demographic profile, etiological spectrum, and outcomes, particularly in South Asia, where socioeconomic and microbial patterns differ from Western countries.

Objective: To evaluate the clinical presentation, risk factors, etiological agents, management strategies, and outcomes of patients with pleural empyema admitted to Jinnah Hospital, Lahore.

Methods: This observational study included 45 patients diagnosed with pleural empyema. Demographic data, comorbidities, clinical features, and radiological findings were recorded. Thoracentesis and microbiological cultures were performed. All patients were managed with chest tube drainage and empirical antibiotics, modified according to culture sensitivity. Hospital stay, need for surgical intervention, and outcomes were documented.

Results: The mean age was 42.9 ± 7.6 years, with male predominance (73%). Diabetes (46%) and hypertension (29%) were the most frequent comorbidities. All cases followed pneumonia, confirming post-pneumonic empyema as the leading cause; only two cases were post tuberculous. Fever was the most common presenting symptom (97%). The mean hospital stay was 12.6 ± 4.3 days. No mortality was recorded, and only one patient required surgical referral. Cultures were sterile in 40% of cases. Among positive cultures, Klebsiella pneumonia (26%) was the most frequent isolate, followed by Pseudomonas aeruginosa (20%) and mixed organisms (2%). Meropenem has 75% sensitivity against klebisella and 77% against pseudomonas showing its effectiveness against these relentless gram negative bacteria.

Conclusion: Pleural empyema in our region predominantly affects middle-aged men with comorbidities, most commonly following pneumonia. Gram-negative organisms are the leading pathogens, underscoring the need for region-specific empiric therapy. Early diagnosis, chest tube drainage, and appropriate antibiotics result in favorable outcomes.