[Treatment of the infected emphysematous bulla].

From 1985 to 1987, we had 4 patients with infected emphysematous bulla, three males and one female ranging from 18 to 61 years of age. The male patients had been suffering from emphysematous bullae and had complications stemming from the resulting infection. In the female case, the infection occurred at the pneumatocele which had grown at pneumonia was caught during steroid therapy for SLE. While all cases were medicated with antibiotics intravenously, they were drained with a small caliber tube percutaneously, then were washed using a cytocidal agent (dilute povidone iodine). In two cases, an infected emphysematous bulla and an infected pneumatocele cleared, then shrank and closed. In the remaining cases, the infected emphysematous bullae also cleared and shrank, then the patients underwent operations. All patients then healed. The therapeutic combination of percutaneous drainage with a small caliber tube and washing of infected emphysematous bulla is available for therapy or preoperative treatment for the following reasons: First of all, especially in patients who have remarkably disturbed pulmonary function, it can be performed safely and pt's symptoms and the general condition of the patient improves rapidly. The second reason is that, in some particular cases, it achieves the remarkable shrinkage and closure of infected emphysematous bulla. The third reason is that, the patients experience minimum pain with the use of a small caliber drainage tube.