Pleural empyema: Etiological aspects and therapeutic problems in Abidjan (Cote d'Ivoire).

We present the results of a retrospective study of 127 cases of empyema admitted to the pneumophtisiology department of the Centre hospitalier universitaire de Treichville (Abidjan), between January 1985 and December 1989. We present the pathogens identified in the pleural fluid and the course of the disease during treatment by repeat thoracocentesis and systemic antibiotics. During the study period pleural empyema represented 2.7 % of all admissions to the pneumophtisiology department, and 20.5 % of those presenting with pleural effusions. Bacteriological examination was recovered in 88 of the 127 patients, and was positive in 57 cases (64.7 % of those examined). Of those with positive bacteriology, 50 (56.8 %) had non-tuberculous bacterial infections, and 7 (7.9 %) had tuberculous infection. Among the non-tuberculous bacterial infections, Gram-negative bacilli were most common (72 %), and Pseudomonas was the species most frequently identified (48 %). The mean stay in hospital was 47 days (range 10-143) and in 82 patients (64.6 %), the outcome was favourable. The presentation was complicated by encystment in 36 cases (28.4 %) and 9 patients (7 %) died in hospital.