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Abstract
Empyema thoracis still remains quite common in developing countries, especially during the hot and humid months.
While most cases would respond to antibiotic therapy, needle aspiration and intercostal drainage, few cases require further surgical management (Light, 2006), The most common etiological micro-organisms are Staphylococcus and Anaerobes.
Tubercular etiology is not uncommon , especially due to delayed presentation, multiresistant strains, mismanaged cases, and noncompliance with antitubercular treatment amidst malnutrition and anemia (Gupta and Shilpa, 2005).
Clinical symptoms, a skiagram chest ”followed by thoracocentesis are usually enough for diagnosis.
Pleura! fluid analysis is usually diagnostic and helps in choosing the appropriate antibiotics.
Further investigations and management depends on the stage of the disease (Medford and Maskell, 2005), There are two basic principles for the successful management ofthoracic empyema - namely, the control of infection with appropriate antimicrobial therapy and the adequate drainage of pus (Acharya and Shahf 2007).
The initial choice of antibiotics depends on the results of Gram’s stain of pleural fluid and sputum.
This is then modified as per the clinical response of the patient and the result of culture and sensitivity.
As a rule, antibiotics are continued until the patient is afebrile and the white blood cell count is