Фотодинамическая терапия при туберкулезной эмпиеме плевры

Treatment efficacy of tuberculous pleural empyema (TPE) with concurrent bronchopleural fistula decreases to 20-25%, thus this pathology serves as a lethal outcome predictor. To enhance treatment efficacy, TPE local sanitation method utilizing antimicrobial photodynamic therapy (PDT) has been developed. This technique is based on the generation of oxygen radicals by the interaction of photosensitizers and light quanta which inactivate Mycobacterium tuberculosis and pyogenic flora. To assess the sanitizing and antimicrobial efficacy of PDT, 96 procedures were performed in 16 patients (in 14 cases, TPE was complicated by bronchopleural fistula, in 10 cases it developed after surgical treatment of pulmonary tuberculosis). After intrapleural instillation of phthalocyanine aluminum 0.5 mg, all walls of the empyema cavity were irradiated by laser radiation with the wavelength of 662 nm and light density of 30-100 J/cm². The response to PDT of tuberculous pleural empyema was reported in 93.75% of cases (n = 15), with complete response observed in 75% of cases (n = 12).