[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"pleural-empyema\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:pleural-empyema":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,45],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":4,"maxAge":4,"enrollmentInfo":17,"targetDuration":4,"studyType":20,"phases":21,"briefSummary":23,"conditions":24,"keywords":28,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":33,"lastUpdatePostDateStruct":34,"startDateStruct":37,"completionDateStruct":39,"leadSponsor":41,"locationsCount":44},"100618928","fungal-empyema-thoracis-100618928",false,"NCT07337993","Fungal Empyema Thoracis","Efficacy of Pleural Lavage With Antifungals in the Management of Fungal Empyema Thoracis: A Prospective Cohort Study","Inclusion Criteria:\n\n* All age patients with confirmed fungal empyema thoracis.\n* Patients with adequate pleural drainage through an intercostal chest tube.\n* Patients receiving systemic antifungal therapy.\n* Patients either:\n\n  1. scheduled for surgical decortication but undergoing lavage as a preoperative adjunct, or\n  2. considered unfit for surgery and managed conservatively.\n\nExclusion Criteria:\n\n* Bacterial empyema without fungal growth.\n* Known hypersensitivity to anti-fungals.\n* Severe hepatic impairment (Child-Pugh class C) contraindicating voriconazole.\n* Pregnancy or lactation.\n* Refusal to participate.","ALL",{"count":18,"type":19},50,"ESTIMATED","INTERVENTIONAL",[22],"NA","Background:\n\nFungal empyema thoracis is a rare but life-threatening pleural infection caused by fungal organisms such as Aspergillus and Candida species. It typically occurs in immunocompromised or debilitated patients and carries a high mortality rate. Conventional management involves systemic antifungal therapy and surgical decortication; however, many patients are unfit for surgery due to poor clinical status or multiple comorbidities. The use of local intrapleural antifungal therapy remains poorly studied.\n\nObjective:\n\nThis study aims to evaluate the efficacy and safety of pleural lavage with voriconazole in patients with fungal empyema thoracis, both as a pre-surgical adjunct and as a palliative measure for patients who cannot undergo surgery.\n\nMethods:\n\nA prospective cohort study will be conducted at the Department of Thoracic Surgery, Services Hospital, Lahore. Patients diagnosed with fungal empyema confirmed by pleural fluid culture or cytology will be included. Through an indwelling chest tube, voriconazole (200 mg in 100 mL normal saline) will be instilled into the pleural cavity once daily for three consecutive days. Patients will be assessed for improvement in clinical symptoms, radiological clearance, reduction in fungal load, and the need for surgical intervention. Data will be statistically analyzed to determine treatment response and safety outcomes.\n\nConclusion:\n\nPleural lavage with voriconazole offers a promising, minimally invasive approach for managing fungal empyema thoracis. If proven effective, this method could serve as a valuable addition to current antifungal strategies, improving outcomes for critically ill patients who are not candidates for surgery.",[25,26,27],"Pyothorax","Fungal Infection Lungs","Pleural Empyema",[29,30,31],"Fungal Pyothorax","pleural lavage","anti-fungals","RECRUITING","2026-01-03",{"date":35,"type":36},"2026-01-13","ACTUAL",{"date":38,"type":36},"2025-07-01",{"date":40,"type":19},"2027-03-31",{"name":42,"class":43},"University of Health Sciences Lahore","OTHER",1,{"id":46,"slug":47,"hasResults":11,"nctId":48,"briefTitle":49,"officialTitle":50,"acronym":51,"eligibilityCriteria":52,"healthyVolunteers":11,"sex":16,"minAge":53,"maxAge":4,"enrollmentInfo":54,"targetDuration":4,"studyType":20,"phases":56,"briefSummary":57,"conditions":58,"keywords":4,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":59,"lastUpdatePostDateStruct":60,"startDateStruct":62,"completionDateStruct":64,"leadSponsor":66,"locationsCount":68},"100369848","vats-surgery-compared-to-drainage-in-the-treatment-of-pleural-empyema-100369848","NCT04095676","VATS Surgery Compared to Drainage in the Treatment of Pleural Empyema","Intrapleural Fibrinolysis and DNase Versus VATS for the Treatment of Pleural Empyema: a Randomized, Controlled Trial","FIVERVATS","Inclusion Criteria:\n\n* 18 years or more on the day of hospitalization\n* Must be able to provide informed consent\n* Acute hospitalization within the last 48 hours\n* Meeting diagnostic criteria for community acquired pleural infection using the following criteria:\n\n  1. A clinical presentation compatible with pleural infection AND\n  2. Has pleural fluid which is either:\n\n     1. purulent pleural fluid or\n     2. gram stain positive or\n     3. culture positive or\n     4. acidic with pH \\\u003C 7.2 or\n     5. low pleural fluid glucose (\\\u003C 2 mmol\u002FL) in the absence of accurate pH measurement or\n     6. septated pleural fluid on ultrasound\n\nExclusion Criteria:\n\n* • Pregnancy. Prior to inclusion of fertile women (defined as the period from menarche to postmenopause) a negative pregnancy test must be available\n* Breastfeeding\n* Declared terminally ill or a predicted survival of less than 3 months\n* Previous intrathoracic surgery (within \\\u003C1 year on the same side of the thorax as where the parapneumonic effusion\u002Fpleural empyema is located\n* Previously (within \\\u003C1 year) hospitalized with with complex parapneumonic effusion (stage II) or pleural empyema (stage III)\n* Drainage during the current admission on the same side of the thorax (excluding diagnostic pleural puncture)\n* Hospitalization within 7 days prior to current hospitalization\n* Previous allergic reaction to alteplase or DNase\n* Use of alteplase therapy contraindicated:\n\n  * Ongoing treatment with oral anticoagulant incl. new oral anticoagulants (e.g. warfarin (Marevan), Dabigatranetexilat (Pradaxa), Rivaroxaban (Xarelto), Apixaban (Eliquis), Endoxaban (Lixiana))\n  * Significant ongoing bleeding or within last six months\n  * Known haemorrhagic diathesis\n  * Previous or suspected intracranial hemorrhage\n  * Suspected subarachnoidal hemorrhage or condition following subarachnoidal hemorrhage from aneurysm\n  * All forms of damage to the central nervous system (e.g. cerebral tumors, aneurysm, intracranial \u002F spinal surgery)\n  * Recent (within 10 days) cardiac resuscitation, birth, or perforation of non-compressible blood vessel (e.g. puncture of v. subclavia, v. jugularis)\n  * Severe, uncontrolled arterial hypertension\n  * Bacterial endocarditis, pericarditis\n  * Acute pancreatitis\n  * Documented ulcerative gastrointestinal disease within last 3 months, esophagal varices, arterial aneurysm, arterio-venous malformations\n  * Tumor \u002F malignancy with an increased risk of hemorrhage\n  * Severe liver disease, including liver failure cirrhosis, portal hypertension (esophagal varices), and active hepatitis\n  * Large operation or significant trauma within previous 3 months","18 Years",{"count":55,"type":19},184,[22],"Pleura empyema is a frequent disease with a high morbidity and a mortality rate of approximately 15%.\n\nPleura empyema is characterized by the passage of three stages (I - III). The aim of treating the disease is to remove the infection and provide fully expansion of the lung.\n\nThe initial treatment at the early stage of the disease (stage I) is simple drainage. In clinical practice, stages II and III are treated alike.\n\nCurrent standard treatment for these stages is drainage with ultrasound (ULS) -guided pigtail. Simultaneously with drainage, an intrapleural fibrinolyticum can be given. A potential better alternative is surgery in terms of Video Assisted Thoracoscopic Surgery (VATS). The theoretical advantage of early surgery is that patients undergo rapid, definitive treatment. Furthermore, surgery can ensure optimal drain placement. How best to treat these patients (drainage or surgery) is still under clinical evaluation and depends to a great extent on local clinical practice. It is only to a limited extent based on scientific evidence.\n\nThe aim of this study is to determine if there is a difference in outcome in patients diagnosed with stage II and stage III empyema who either receive primary VATS surgery or ULS guided drainage and intrapleural therapy (fibrinolytic (altaplasm) with DNase (Pulmozyne ®)) The primary outcome is Hospitalization time and secondary outcomes is e.g. mortality, health related costs and quality of life.\n\nThe present study can thus provide new and highly relevant knowledge as well as change the treatment of these patients, both nationally and internationally.\n\nIt is planned that a total of 184 patients will be included in the project. The study takes place as a collaboration between all four thoracic surgical departments and the major pulmonary medicine departments in Denmark. In addition, the study has international collaborators\u002Fconsultants who will provide counselling in connection with the study.",[27],"2025-09-30",{"date":61,"type":36},"2025-10-03",{"date":63,"type":36},"2022-10-30",{"date":65,"type":19},"2028-10-30",{"name":67,"class":43},"Thomas Decker Christensen",3]