@article {DavoodabadiP2401, author = {Abdolhossein Davoodabadi and Hassan Adeli and Ebrahim Razi}, title = {TB empyema}, volume = {40}, number = {Suppl 56}, elocation-id = {P2401}, year = {2012}, publisher = {European Respiratory Society}, abstract = {BackgroundParapneunomonic effusion mostly is resolved with medical management but sometims became complicated. We studied the etiology and possible underlying causes of it.MATERIALS AND METHODstudy on 81 patients with postpneumonic empyema which required decortication carried out. in Kashan, Shahid Beheshti General Hospital, from Oct 2007to Des 2011, Management of patients such as appropriate antibiotic, and thoracostomy tube drainage was done in internal medicine ward. Complicated cases were referred to us for thoracotomy and decortication.Sex, age, occupation, possible risk factors, surgical methods, pathological results and complications were considered.43of the patients underwent posterolateral thoracotomy,and the rest by VATS, complete evacuation of fibrin clots, septae, necrotic tissue, fluid from the pleural cavity and fully expansible lung was achieved.ResultsPatients{\textquoteright} age ranged from 17 to 76 with a mean of 46 years.F/M was 5:1 The most common clinical findings were fever (88\%), pleural dull pain (81\%), productive cough (74\%) and dyspnea (71\%). PPD test was negative in all patients. ESR(25-50)=72\%and tee rest\>100.In 78\%, white cell count was normal; in remainder it was more than 11.000. Bacteriological findings were negative and acid fast basili were not detected. Tissue diagnosis after decorticating showed tuberculosis in 20(24\%) patients and necrotic tissue in remainder. Morbidity rates were acceptable and there was 2late mortality.CONCLUSION: in parapneumonic effusion not responding to standard treatments, tuberculosis as an underlying cause must be considered, specially in addicted patuents, or ESR \>100. Once medical therapy is seemed to have failed, early VATS or thoracotomy and decortication is recommend. This may identify underlying causes.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/Suppl_56/P2401}, eprint = {https://erj.ersjournals.com/content/40/Suppl_56/P2401.full.pdf}, journal = {European Respiratory Journal} }