Stages of Empyema thoracis (Para-pneumonic)
Severity Scoring of Empyema (SSE)
The following scoring system was described by Hoff et al to allow comparison of empyema thoracis in children.
Parameters:
One point is allocated to each parameter that is present. A total score of :
- Early / acute / serous stage, one or more of:
•pH < 7.2
•glucose < 40 mg/dL
•LDH >1000IU/dL
•protein > 2.5 g/dL
•WBC > 500/µL
•specific gravity greater than 1.018
•Thin serous or cloudy fluid, generally sterile - Fibrinopurulent / intermediate stage
•Thicker, opaque fluid or fluid with positive cultures - Organizing / late stage
•An organizing peel with entrapment of the lung
Severity Scoring of Empyema (SSE)
The following scoring system was described by Hoff et al to allow comparison of empyema thoracis in children.
Parameters:
- Low pleural fluid pH (<7.2)
- Low pleural fluid glucose (<40 mg.dl)
- Significant scoliosis on CXR
- Evidence of parenchymal entrapment
- Anaerobic infection
One point is allocated to each parameter that is present. A total score of :
- Mild disease (can be treated with antibiotics and thoracentesis
- Moderate disease
- Severe disease (will “defervesce” more rapidly with surgical decortication)
![]()
|
![]()
|