Successful treatment of late onset empyema after extrapleural pneumonectomy: A case report

• Main Authors: Shigeto Nishikawa, Shigeyuki Tamari, Kenji Okita, Koji Chihara
• Format: Article
• Language: English
• Published: Elsevier 2019-01-01
• Series: Respiratory Medicine Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007118303708

Treatment of post-extrapleural pneumonectomy empyema (PEPPE) is more difficult than that for post-pneumonectomy empyema for two reasons: first, a large infectious dead space remains after extrapleural pneumonectomy (EPP); and second, defects of the pericardium and diaphragm are reconstructed with artificial materials, which ideally should be removed for treatment of infection. Here, we report the case of a 56-year-old male with PEPPE that occurred long after EPP for mesothelioma. The patient was treated successfully by minimally invasive procedures of irrigation, instillation of urokinase and antibiotics, and surgical debridement without peeling off artificial materials. Keywords: Late onset empyema, Minimally invasive surgery, Extrapleural pneumonectomy, Malignant mesothelioma