Empyema and the urban black.

Fifty consecutive Black patients with thoracic empyema were studied retrospectively. The causes of the empyema were penetrating thoracic trauma (27 cases), lung abscess (10), post-aspiration pulmonary disease (4), and pulmonary and pleural tuberculosis (4); a miscellaneous group of 5 patients had empyema complicating an infected pulmonary cyst, a hepatic amoebic abscess, necrotic pulmonary lymphoma, thoracic actinomycosis and blunt thoracic trauma. Fourteen patients had bronchopleural fistulas. Patients were treated by closed-tube thoracostomy drainage alone (6 cases), rib resection and drainage (36), pulmonary decortication alone (3), and pulmonary decortication in association with a thoracic operative procedure (5). Results of treatment were good in the majority of patients with empyema (41), in 7 cases results were poor, and 2 patients died. Serious underlying pulmonary disease was responsible for treatment failure. Empyema in the urban Black is associated with prolonged morbidity and severe social consequences.