[Intrapleural fibrinolysis with streptokinase in th treatment of loculated empyema].

Intrapleural fibrinolytic treatment is increasingly used in patients with loculated empyema. In this paper, we report our experience with fibrinolytic therapy in eight patients with empyema not responding to drainage and antibiotics. Mean patient age was 47 (range 3-76), and mean duration of symptoms 14 weeks (range 1-24). The patients were treated with 250,000 IU streptokinase in four hours, 1-6 intrapleural instillations (except 50,000 IU for the child). Between 500 and 4,500 cc fluid was drained. Mean drainage time was 14 days (range 6-20). Mean time spent in hospital was 20 days (range 15-25). No microbiological agent was isolated in three patients. All patients recovered. One patient experienced a hypersensitivity reaction following streptokinase treatment for more than one week. Fibrinolysis with streptokinase should be used in patients with loculated empyema when drainage and antibiotics fail.