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Empyema of the thorax.

We conclude that following diagnostic thoracentesis, it is appropriate to attempt therapeutic thoracentesis in selected patients with thoracic empyema (especially in the pediatric population). One must be quick, however, to initiate chest tube drainage should this conservative approach fail. The need for prolonged open drainage, such as an Eloesser flap has proved to be indicated seldom for the treatment of thoracic empyemas. Every child was effectively treated with thoracentesis or chest tube drainage alone; none required surgical intervention. Thoracic empyemas can be managed effectively with less aggressive surgical treatment. Rationale and appropriate use of the various drainage methods in as progressive manner are associated with minimal morbidity and mortality.