Noninvasive mechanical ventilation and pulmonary empyema

Thoracic empyema is defined by the presence of pus in the pleural space. It is a critical condition which has a worse prognosis in nosocomial infections. The most frequent cause is a history of pneumonia. Associated risk factors include advanced age, type 2 diabetes mellitus, malnutrition, poor oral hygiene, cancer, among others. We present the case of a 45-year-old white female patient, with an apparently healthy past medical history. She presented a clinical productive cough accompanied by mucopurulent sputum, with pleuritic pain on the side, fever of 39 - 40 ºC, night sweats, asthenia and anorexia. When arriving at the emergency room she presented clinical evidence of respiratory failure and elements of sepsis. The clinical findings, thoracentesis, cultures and Gram staining, as well as the imaging studies confirmed the diagnosis of pneumococcal pulmonary empyema. Noninvasive mechanical ventilation and antibiotic therapy were applied. The patient progressed favorably.