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Correspondence
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Volume 352:2243-2245 May 26, 2005 Number 21
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A Trial of Intrapleural Streptokinase

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 by Maskell, N. A.
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To the Editor: The design and execution of the First Multicenter Intrapleural Sepsis Trial (MIST1), reported by Maskell et al. (March 3 issue),1 are discordant with the contemporary management of pleural-space infections. The anatomical features of complicated pleural-space infections are better characterized by thoracic ultrasound and computed tomographic scanning.2 Frontal radiography used as the sole imaging method is grossly inadequate for this purpose. Knowing the extent of pleural septation and spatial separation of infected locules is essential for the management of thoracostomy drains, use of thrombolytic agents, and decisions about surgical management. Even when used in conjunction with clinical and . . . [Full Text of this Article]


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