A case of posttraumatic empyema thoracis after an animal attack

Abstract

We report a case of extrinsic empyema thoracis occurring as a complication of severe chest wound . A 22-year-old zookeeper was attacked by a lion. He underwent urgent surgery at another hospital to control right intrapleural hemorrhage from multiple rib fractures and torn lung parenchyma. The patient was referred to our hospital for treatment of postoperative empyema 4 days after the accident. The empyema was secondary to a large gangrenous area in the chest wall.Following extensive debridement and intrapleural irrigation during a second thoracotomy, the patient was successfully treated by 4 weeks of closed thoracic drainage and positive airway pressure ventilation.The patient was discharged 87 days after the second surgical intervention. In such cases, sufficient surgical debridement followed by positive airway pressure ventilation is necessary to control the infectious foci of extrinsic empyema.