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The therapeutic role of intrapleural streptokinase is explored. The results reveal that intrapleural administration of streptokinase does not improve mortality, the rate of surgery, or the length of the hospital stay among patients with pleural infection.

The article focuses on the study which examines the relationship between the sizes of the chest tubes and outcomes in patients with pleural infection. The study states that the clinical outcomes is similar in patients treated with different chest tube sizes for pleural infection but smaller-size tubes cause less pain. It mentions that smaller size tubes is said to be the initial treatment for pleural infection.

The article discusses whether protein tyrosine phosphatase PTPN22 R620W polymorphism is associated with susceptibility to invasive bacterial infection. PTPN22 Trp620 variant has been found to be associated with susceptibility to invasive pneumococcal disease and gram-positive empyema. This findings suggest that some autoimmune susceptibility alleles may also confer susceptibility to infectious disease.

The article presents the 2010 British Thoracic Society pleural disease guidelines on the management of pleural infection in adults. These guidelines target predominantly at doctors involved in adult in general and respiratory medicine. A historical perspective, pathophysiology and bacteriology of pleural infection is provided. Among the topics not discussed in the guidelines are paediatric empyema and tuberculous empyema.

Background: The role of the innate immune protein mannose-binding lectin (MBL) in host defence against severe respiratory infection remains controversial. Thoracic empyema is a suppurative lung infection that arises as a major complication of pneumonia and is associated with a significant mortality. Although the pathogenesis of thoracic empyema is poorly understood, genetic susceptibility loci for this condition have recently been identified. The possible role of MBL genotypic deficiency in susceptibility to thoracic empyema has not previously been reported., Methods: To investigate this further we compared the frequencies of the six functional MBL polymorphisms in 170 European individuals with thoracic empyema and 225 healthy control individuals., Results: No overall association was observed between MBL genotypic deficiency and susceptibility to thoracic empyema (2 x 2 Chi square = 0.02, P = 0.87). Furthermore, no association was seen between MBL deficiency and susceptibility to the Gram-positive or pneumococcal empyema subgroups. MBL genotypic deficiency did not associate with progression to death or requirement for surgery., Conclusions: Our results suggest that MBL genotypic deficiency does not associate with susceptibility to thoracic empyema in humans.

Talc pleurodesis is commonly used in the palliative treatment of malignant pleural effusions but the shortest and most effective regime has not been determined. In particular, it is not clear when the intercostal drain should be removed following the insertion of sclerosant. We conducted a single-centre, randomised, open trial of drain removal at 24 h versus 72 h following talc slurry pleurodesis. The primary outcome measure was success of pleurodesis (no recurrence of effusion on chest radiograph at 1-month follow-up) and secondary outcome measures included length of hospital stay and mortality. We found no difference between recurrence of pleural effusion in those randomised to drain removal at 24 h and those randomised to drain removal at 72 h (p>0.5). However, length of stay was significantly reduced when the chest drain was removed at 24 h (4 days versus 8 days; p<0.01). Mortality did not differ between the two groups. We conclude that this shorter pleurodesis regime is safe and effective.