Efficacy and safety of intrapleural streptokinase in tubercular empyema thoracis – old wine in new wineskin

Author:

Goel Rishabh1,Singh Gajendra Vikram2,Shadrach Benhur Joel1ORCID,Deokar Kunal3,Kumar Santosh4,Rajput Karamvir Singh1

Affiliation:

1. Department of Tuberculosis & Chest Diseases, Sarojini Naidu Medical College, Agra

2. Associate Professor, Department of Tuberculosis & Chest Diseases, Sarojini Naidu Medical College, Agra

3. Attending Consultant, Department of Pulmonary Medicine, Sapphire Hospital, Mumbai

4. Professor and Head, Department of Tuberculosis & Chest Diseases, Sarojini Naidu Medical College, Agra

Abstract

Tubercular empyema thoracis continues to be one of the leading causes of morbidity in low-income countries. Despite antitubercular therapy (ATT) and thoracostomy, empyema drainage is hampered by multiple septations, loculations, debris, and blood clots leading to complications. In a comparative experimental study to estimate the efficacy and safety of intrapleural streptokinase (IPSTK) in tubercular empyema, 30 cases of chronic multiloculated tubercular empyema were compared by radiological improvement by chest radiography, duration and volume of fluid drained, and degree of dyspnoea according to the modified Borg scale, depending on whether streptokinase was used or not. The former scored on all counts; we therefore conclude that intrapleural streptokinase is a safe, efficacious intervention in tubercular empyema. It decreases morbidity and reduces the need for surgery.

Publisher

SAGE Publications

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health

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