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Pleural catheter AND infection

Cristiano Silva Cruz, Valentina Tosatto, Paula Oliveira Nascimento, Rita Barata Moura
Hepatic hydrothorax, a rare and debilitating complication of cirrhosis, carries high morbidity and mortality. First-line treatment consists of dietary sodium restriction and diuretic therapy. Some patients, mainly those who are refractory to medical management, will require invasive pleural drainage. The authors report the case of a 76-year-old man in a late cirrhotic stage of alcoholic chronic liver disease, presenting with recurrent right-sided hepatic hydrothorax, portal hypertension, hepatosplenomegaly and thrombocytopaenia...
March 15, 2019: BMJ Case Reports
Neslihan Cihanoglu, Riza Adaleti, Yasar Nakipoglu
BACKGROUND: We aimed to investigate the frequency of fibronectin binding protein (FBP), which is part of the first step of adhesion, and Panton-Valentine leukocidin (PVL) toxin, which contributes to the destruction of host leukocytes and tissue necrosis, in clinical S. aureus strains. METHODS: One hundred S. aureus strains were included in the study and distributed as follows; 33 from skinwound swabs and catheter tips (SWCT), 33 from body fluid and secretion specimens (BSFS) such as tracheal aspirate, sputum, and pleural effusion fluid, 18 from tissue biopsy specimens (TBS), 10 specimens from blood, and related specimens (BRS) such as bone marrow, and cerebral spinal fluid, and six specimens from mucosal membrane of pharynx, nose, and vagina (MMS)...
January 1, 2019: Clinical Laboratory
Shichen Wang, Mingjin Zhang, Chenggong Zhao, Yang Li, Yeyun Li, Shangchuan Chen, Liang Chen, Xiaoming Wei, Bo Liu, Ying Ye
OBJECTIVE: To investigate the clinical efficacy of continuous irrigation combined with closed thoracic drainage for esophagojejunal anastomotic fistula (EJAF) complicated with mediastinal, thoracic and abdominal infection after total gastrectomy. METHODS: Clinical data of 22 EJAF patients complicated with mediastinal, thoracic and abdominal infection after radical gastrectomy at Department of General Surgery of the 901th Hospital of PLA from June 2012 to May 2018 were retrospectively analyzed...
December 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
A S Sagar, Georgie A Eapen, Roberto F Casal, David Ost, Mona Sarkiss, Horiana B Grosu
BACKGROUND: The use of pleuroscopy has expanded over the last decade due to its higher diagnostic yield and low complications rate. Whether the infectious complications of pleuroscopy performed in negative pressure rooms is similar to that of pleuroscopy performed in positive pressure rooms remain unclear. To assess the safety of pleuroscopy performed in negative pressure rooms, we sought to determine the rate of infectious complications in patients who underwent pleuroscopy in negative pressure bronchoscopy rooms at our institution...
December 12, 2018: Journal of Bronchology & Interventional Pulmonology
Amos Lal, Jamal Akhtar, Ashfaq Ullah, George M Abraham
Staphylococcus simulans is a coagulase-negative organism, mainly an animal pathogen. Reports of human infection have been infrequent, mainly in patients with repeated animal contact. We report the first case of pleural empyema in an elderly woman. S. simulans tends to cause more severe infection because of a biofilm layer which helps in adherence and colonization of smooth surfaces, especially prosthetic devices, shunts, and catheters. The challenging problem even after CoNS isolation and identification is the assessment of their clinical relevance...
2018: Case Reports in Infectious Diseases
Saad Habib, Nicholas Fuca, Mohammed Azam, Abdul Hasan Siddiqui, Kartikeya Rajdev, Michel Chalhoub
Achromobacter xylosoxidans , a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans /denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR Escherichia coli and Streptococcus anginosus . A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. He was found to have pleural empyema secondary to MDR E...
2018: Respiratory Medicine Case Reports
Adnan Majid, Andres de Lima, Mihir Parikh, Alex Chee, Sebastian Fernandez-Bussy, Fayez Kheir
Chronic pleural infection is characterized by thickened pleura and nonexpandable lung often requiring definitive surgical intervention, such as decortication and/or pleural obliteration procedures. Such procedures are associated with significant morbidity and require proper patient selection for a successful outcome. We report a cohort of 11 patients with pleural space infection and a nonexpandable lung treated with tunneled pleural catheters (TPCs). Following placement, hospital discharge and TPC removal occurred after a median of 5 and 36 days, respectively...
October 22, 2018: Journal of Bronchology & Interventional Pulmonology
Rajeev Nayan Priyadarshi, Vijay Prakash, Utpal Anand, Prem Kumar, Ashish Kumar Jha, Ramesh Kumar
OBJECTIVE: To determine the efficacy and safety ultrasound-guided percutaneous catheter drainage (US-PCD) in management of various types of ruptured amebic liver abscess including free rupture (FR) with diffuse intraperitoneal fluid collections (DIFC). METHODS: This study analyzed 117 patients with ruptured ALA who underwent US-PCD. The indication for US-PCD was failure to respond to conservative treatment and/or percutaneous needle aspiration. RESULTS: Majority of patients were locally fermented alcohol abusers (95%), and malnourished (75%)...
October 25, 2018: Abdominal Radiology
Muhammad A Baig, Muhammad B Majeed, Bashar M Attar, Zubair Khan, Melchor Demetria, Seema R Gandhi
Hepatic hydrothorax (HH) is an infrequent but debilitating and therapeutically challenging complication of advanced liver cirrhosis. As evidence suggests against chest tube placement in HH, many clinicians are reluctant to place indwelling pleural catheters (IPCs) for non-malignant effusions like HH. We aim to study the efficacy and safety of IPCs as an alternative treatment option in our systematic review. A literature search was conducted using the electronic database engines MEDLINE, PubMed, EMBASE, Ovid, Scopus and Cochrane Library (Cochrane Central Register of Controlled trials and Cochrane Database of Systematic Reviews) from inception to April 2018 to identify published articles and reports addressing outcomes in patients treated for HH with IPCs...
August 6, 2018: Curēus
David J Feller-Kopman, Chakravarthy B Reddy, Malcolm M DeCamp, Rebecca L Diekemper, Michael K Gould, Travis Henry, Narayan P Iyer, Y C Gary Lee, Sandra Z Lewis, Nick A Maskell, Najib M Rahman, Daniel H Sterman, Momen M Wahidi, Alex A Balekian
BACKGROUND: This Guideline, a collaborative effort from the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology, aims to provide evidence-based recommendations to guide contemporary management of patients with a malignant pleural effusion (MPE). METHODS: A multidisciplinary panel developed seven questions using the PICO (Population, Intervention, Comparator, and Outcomes) format. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the Evidence to Decision framework was applied to each question...
October 1, 2018: American Journal of Respiratory and Critical Care Medicine
Anthony M Villano, Raul Caso, M Blair Marshall
Malignant pleural effusion (MPE) is a common and complex manifestation of advanced stage cancer. Treatment options have trended towards less invasive approaches such as intrapleural catheter drainage, however this technique is not without morbidity and not suitable for every patient. A troublesome scenario arises when an MPE is secondarily infected in the setting of an indwelling catheter, given both the high frequency of recurrence of such fluid and the presence of a foreign body. Further, quality literature surrounding this specific management issue is sparse and thus practice is heterogeneous...
2018: AME Case Reports
Lokesh Yagnik, Ranjan Shrestha
Indwelling pleural catheters (IPCs) are increasingly used for the management of symptomatic malignant pleural effusion worldwide. IPCs have been documented to reduce the number of hospital bed days in patients with malignant pleural effusion and thus are often used as the preferred mode of management in fit healthy patients with good performance status. Complications related to IPCs, mainly in the form of pleural infection and needle tract metastasis, are well reported in the literature. Similarly, fracture of IPCs is a recognized complication during the process of IPC removal...
November 2018: Respirology Case Reports
Rachelle Asciak, Robert John Hallifax, Rachel Mary Mercer, Maged Hassan, Charlotte Wigston, John M Wrightson, Ioannis Psallidas, Najib Mahboob Rahman
BACKGROUND: Indwelling pleural catheters (IPC) offer an alternative to talc pleurodesis in recurrent effusion, especially in patients wishing to avoid hospitalization. Two randomized trials have demonstrated reduced time in hospital using IPCs versus talc pleurodesis in malignant pleural effusion (MPE). However, the impact of IPCs on hospital services and patients has not been well studied. OBJECTIVES: To analyze long-term outcomes of IPCs and understand the hospital burden in terms of requirement for hospital visits and contacts with healthcare, while the IPC was in situ...
September 18, 2018: Respiration; International Review of Thoracic Diseases
Samira Shojaee, Najib Rahman, Kevin Haas, Ryan Kern, Michael Leise, Mohammed Alnijoumi, Carla Lamb, Adnan Majid, Jason Akulian, Fabien Maldonado, Hans Lee, Marwah Khalid, Todd Stravitz, Le Kang, Alexander Chen
BACKGROUND: The outcome of indwelling pleural catheter (IPC) use in hepatic hydrothorax (HH) is unclear. This study aimed to review the safety and feasibility of the IPC in patients with refractory HH. METHODS: A retrospective multicenter study of patients with HH from January 2010 to December 2016 was performed. Inclusion criteria were refractory HH treated with an IPC and an underlying diagnosis of cirrhosis. Records were reviewed for patient demographics, operative reports, and laboratory values...
August 29, 2018: Chest
Sanjeevan Muruganandan, Maree Azzopardi, Deirdre B Fitzgerald, Ranjan Shrestha, Benjamin C H Kwan, David C L Lam, Christian C De Chaneet, Muhammad Redzwan S Rashid Ali, Elaine Yap, Claire L Tobin, Luke A Garske, Phan T Nguyen, Christopher Stanley, Natalia D Popowicz, Christopher Kosky, Rajesh Thomas, Catherine A Read, Charley A Budgeon, David Feller-Kopman, Nick A Maskell, Kevin Murray, Y C Gary Lee
BACKGROUND: Indwelling pleural catheters are an established management option for malignant pleural effusion and have advantages over talc slurry pleurodesis. The optimal regimen of drainage after indwelling pleural catheter insertion is debated and ranges from aggressive (daily) drainage to drainage only when symptomatic. METHODS: AMPLE-2 was an open-label randomised trial involving 11 centres in Australia, New Zealand, Hong Kong, and Malaysia. Patients with symptomatic malignant pleural effusions were randomly assigned (1:1) to the aggressive (daily) or symptom-guided drainage groups for 60 days and minimised by cancer type (mesothelioma vs others), performance status (Eastern Cooperative Oncology Group [ECOG] score 0-1 vs ≥2), presence of trapped lung, and prior pleurodesis...
September 2018: Lancet Respiratory Medicine
Xiaohe Yu, Shaojie Yue, Mingjie Wang, Chuanding Cao, Zhengchang Liao, Ying Ding, Jia Huang, Wen Li
We aimed to investigate the incidence and risk factors associated with nonselective removal of peripherally inserted central venous catheter (PICC) in neonates. In this prospective cohort study, neonates who underwent PICC placement at neonatal intensive care units (NICUs) in China from October 2012 to November 2015 were included. The patient demographics, catheter characteristics, catheter duration, PICC insertion site, indication for PICC insertion, infuscate composition, PICC tip location, and catheter complications were recorded in a computerized database...
2018: BioMed Research International
Sushilkumar Satish Gupta, Charalampos S Floudas, Abhinav B Chandra
Background: Malignant pleural effusion (MPE) is a common cause of quality of life deterioration in patients with advanced cancer. Management options include chemical pleurodesis with a sclerosing agent such as doxycycline or talc powder, surgery, and also the placement of tunneled indwelling pleural catheters (IPCs). Two different IPC types are mostly used in the USA. Methods: We conducted a single-center retrospective study with the objective to compare the efficacy and safety profiles of two IPC systems...
May 2018: Journal of Thoracic Disease
Erik Vakil, Carlos A Jimenez, Saadia A Faiz
PURPOSE OF REVIEW: Pleural effusions in patients with hematologic malignancy may represent malignant pleural effusion (MPE) or occur secondary to infection, treatment effects, and other common causes. The impact of MPE on prognosis in this cohort remains unclear. Indwelling pleural catheters (IPCs) are routinely placed for palliation of recurrent symptomatic MPEs, but perceived concerns over infection and bleeding may limit their use in patients with hematologic malignancies. However, recent evidence suggests IPCs are both well tolerated and effective in this cohort...
July 2018: Current Opinion in Pulmonary Medicine
Rachel M Mercer, Maged Hassan, Najib M Rahman
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice...
April 2018: Expert Review of Respiratory Medicine
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
April 2018: Tuberculosis and Respiratory Diseases
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