dc.contributor.author | Nyamohanga, Patrick M | |
dc.date.accessioned | 2013-10-25T13:09:27Z | |
dc.date.available | 2013-10-25T13:09:27Z | |
dc.date.issued | 2013 | |
dc.identifier.citation | Degree Of Master Of Medicine (M.MED) In General Surgery, University Of Nairobi, 2013 | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/57921 | |
dc.description.abstract | Background:
Emphysema thoracis accounts for 23% of chest related complications in Human Immunodeficiency Virus-Acquired immunodeficiency Syndrome (HIV/ AIDS) and is a frequent complication of pneumonia in patients with HIV. Patients infected with HIV developing empyema thoracis tend to present late and are sometimes subjected to different management modalities with a lot of complications. Existing literature shows that this results in long hospital stay, high morbidity and mortality and that HIV infection has changed the pattern of presentation of many diseases. A clear understanding of symptoms, signs and microbial causes will help bridge the knowledge gap leading to early diagnosis and shortened hospital stay among these patients.
Objective: To compare the symptoms, signs and microbial causes of empyema thoracis between HIV and non HIV infected patients.
Study design: Cross-sectional comparative study at Kenyatta National Hospital over 4 month’s duration between December 2012 and April 2013.
Methods and materials: We recruited 32 HIV infected patients and 32 non HIV infected patients making up a total of 64 subjects using convenient sampling method. Independent variables were presence or absence of HIV infection. The dependent variables were signs, symptoms and microbiology of empyema thoracis.
Statistical analysis: Graph Pad Instat ™ version 2.04 statistical software was used for analysis of data. The p value of equal or less than 0.05 was considered significant.
Results: Thirty six males (56.25%) and 28 females (43.75%) participated. Chest pain was the most common and consistent symptom in both HIV infected and non-HIV infected patients, 100% and 97% respectively. Cough was the second commonest symptom seen in 97% of HIV and 84% of non-HIV infected. Weight loss was noted in 81.3% of HIV and 53.1% of non-HIV infected patients. Patients without HIV infection presented with massive pleural pus with midline shift in 43.8%, while those with HIV infection only 15% had a noticeable midline shift. Whereas 81.3% of HIV infected patients reported fever prior to hospital admission only 68% had clinically demonstrable fever. Among the non-HIV infected, 66.4% reported febrile illness but only 59% had demonstrable fever. The commonest etiological factor among the HIV infected patients was TB (50%) and Para pneumonia (47%). In non-HIV infected patient’s malignancies (34%) and iatrogenic causes mainly chest tube insertions (32%) were the main etiological factors. The most common cultured organism in HIV infected were pseudomonas spp (25%) while Staphylococcus aureus were the most common isolates among non HIV infected at 34%.
Conclusion: Chest pain is the most common and consistent symptom in both HIV and non-HIV infected patients presenting with empyema thoracis. Aseptic technique should be observed during chest tube insertion at all times. | en |
dc.language.iso | en | en |
dc.publisher | University of Nairobi | en |
dc.title | Comparison of empyema thoracis presentation between HIV infected and non HIV infected patients as seen at a Tertiary Hospital In Kenya. | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Surgery | en |