Treatment Of Pyothorax Research Articles

A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats.

To review the current literature in reference to the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. Pyothorax, also known as thoracic empyema, is characterized by the accumulation of septic purulent fluid within the pleural space. While the actual route of pleural infection often remains unknown, the oral cavity and upper respiratory tract appear to be the most common source of microorganisms causing pyothorax in dogs and cats. In human medicine, pyothorax is a common clinical entity associated with bacterial pneumonia and progressive parapneumonic effusion. Thoracic imaging can be used to support a diagnosis of pleural effusion, but cytologic examination or bacterial culture of pleural fluid are necessary for a definitive diagnosis of pyothorax. The approach to treatment for pyothorax varies greatly in both human and veterinary medicine and remains controversial. Treatment of pyothorax has classically been divided into medical or surgical therapy and may include administration of antimicrobials, intermittent or continuous thoracic drainage, thoracic lavage, intrapleural fibrinolytic therapy, video-assisted thoracic surgery, and traditional thoracostomy. Despite all of the available options, the optimal treatment to ensure successful short- and long-term outcome, including the avoidance of recurrence, remains unknown. The prognosis for canine and feline pyothorax is variable but can be good with appropriate treatment. A review of the current veterinary literature revealed an overall reported survival rate of 83% in dogs and 62% in cats. As the clinical presentation of pyothorax in small animals is often delayed and nonspecific, rapid diagnosis and treatment are required to ensure successful outcome.

Clinical conundrum

Abstract An 18-month-old English Springer Spaniel presented with a 5 day history of depression, inappetence and laboured breathing. Diagnosis and treatment of pyothorax are described.

Medical treatment of pyothorax

Medical treatment of pyothorax

Pyothorax in nine dogs

Summary The results of treatment of pyothorax using systemic antibiotics, drainage, and lavage of the pleural space, are reported for 9 dogs. All 9 dogs recovered completely. In 8 of the 9 dogs the follow‐up period was at least 6 months and in none was there a relapse. The results obtained with this treatment are excellent in comparison with the results that have been reported for treatment with systemic antibiotics and drainage of the pleural space but without lavage. Apart from the addition of pleural lavage to the treatment protocol, the better result might be because migrating plant related foreign bodies did not seem to play an important role in the pathogenesis of pyothorax in this group of dogs.

動脈管開存症術後に発症したＭＲＳＡ膿胸，仮性動脈りゅうの１救命例

動脈管開存症術後にMRSA膿胸, 大動脈破裂, 仮性大動脈瘤を発症した1例を救命した. 症例は24歳, 女性. 初回手術で動脈管切離術を施行後, 第5病日に創部から排膿した. 第8病日にはMRSA感染による大動脈破裂で左緊張性血胸となり緊急手術を施行した. 手術は循環停止下に止血術を行い, 一期的に大網充填術を行った. 術後は緑膿菌による肺炎と, 急性腎不全を併発したが, 保存的治療で治癒した. 第37病日に下行大動脈に仮性瘤を形成し, 拡大傾向にあったため, 第56病日に人工血管置換術を施行した. その後は良好に経過した. 一期的な大網充填術は, 感染活動期のMRSAによる重症感染症に対し, 極めて有用な方法であった.

The Treatment of Pyothorax

The Treatment of Pyothorax