Thoracoscopy for Parapneumonic Effusions and Empyema

Parapneumonic effusion and empyema are still an important medical problem since they remain a significant cause of morbidity and mortality (Davies et al. 1999; Farjah et al. 2007). Risk factors for the development of empyema include alcohol abuse, aspiration and poor dental hygiene, chronic lung disease, diabetes mellitus, gastroesophageal reflux, rheumatoid arthritis, and intravenous drug abuse (Ferguson et al. 1996). About one third of cases occur without any identified risk factors (Ferguson et al. 1996; Davies et al. 2003), suggesting that the host immune defense system or modification in bacterial virulence may also play important roles.