A case of pyothorax after treatment of burn inhalation injury. A case report

Introduction: Inhalation injury is a major complication of fire accidents. Delayed onset of tracheal stenosis is one of the chronic complications of inhalation injury. Here, we report a case of acute empyema as a complication of inhalation injury.Presentation of case: A 38-year-old-man who underwent a tracheostomy following an inhalation injury when he was 25-years of age was admitted with a diagnosis of right-side pyothorax. We attributed the pyothorax to insufficient bronchial toilet secondary to preoperative tracheal stenosis and tracheal mucosal damage as a complication of inhalation injury, as confirmed using laryngofiberscopy. Conservative therapy was insufficient, therefore, surgical drainage was performed. At the time of surgery, following general anesthesia induction, the insertion of a single-lumen tube was difficult owing to severe tracheal stenosis. As a result, we performed an emergency tracheostomy followed by empyema curettage. Discussion/conclusion: Tracheal stenosis due to tracheal basal membrane injury and mucosal membrane injury resulted in sputum clearance disorder. These changes led to pyothorax. Preoperative airway safety should be carefully planned when operating on patients with tracheal stenosis.