[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-408764-105":59,"doc-detail-408764-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","smoking-as-a-contributing-factor-in-the-development-of-empyema","Smoking as a Contributing Factor in the Development of Empyema","","Empyema involves pus accumulation in the pleural cavity, commonly as a complication of pneumonia. This retrospective study evaluated oral health in patients with acute empyema and examined associations between empyema development and oral bacteria or smoking status. Forty-five surgical patients (July 2020–July 2023) were grouped by pleural fluid culture results and compared for oral health parameters. Group B showed higher smoking indices, poorer hygiene, and specific clinical differences, supporting smoking as a cofactor beyond oral bacteria.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/smoking-as-a-contributing-factor-in-the-development-of-empyema/408764/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/smoking-as-a-contributing-factor-in-the-development-of-empyema/408764.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this study on acute empyema?","Question",{"text":112,"@type":113},"The study evaluated oral health in acute empyema patients and explored whether oral bacteria or smoking status were associated with empyema development.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients grouped in the methods?",{"text":117,"@type":113},"Patients were categorized based on pleural fluid cultures into three groups: oral commensal bacteria (Group A), non-oral bacteria (Group B1), and culture-negative cases (Group B2).",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find about smoking and empyema?",{"text":121,"@type":113},"Group B showed a significantly higher smoking index than Group A, and smoking was associated with empyema cases not linked to oral bacteria, supporting a dual-pathway hypothesis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},408764,1790791739,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review began 10/25/2025  \nReview ended 11/25/2025  \nPublished 11/30/2025  \n© Copyright 2025  \nNanaumi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98200  \nOpen Access Original Article  \nSmoking as a Contributing Factor in the Development of Empyema  \nHiroto Nanaumi 1 , Nanaha Okida 2, Hiroyuki Nakano 1, Mayumi Yamamura 2, Yasuhisa Sawai 1 , Yota Yamauchi 1, Satoshi Wada 1, Eiji Mitate 1 , Shun Iwai 3, Hidetaka Uramoto 3  \n1. Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Uchinada, JPN 2. Department of Oral Hygiene, Kanazawa Medical University Hospital, Uchinada, JPN 3. Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, JPN  \nCorresponding author: Hiroyuki Nakano, [nakano-h@kanazawa-med.ac.jp](nakano-h@kanazawa-med.ac.jp)  \nAbstract  \nBackground and aim: Empyema is characterized by the accumulation of pus in the pleural cavity, often arising as a complication of pneumonia. This study aimed to evaluate oral health in patients with acute empyema and to explore whether oral bacteria or smoking status were associated with empyema development.  \nMethods: This retrospective study included 45 patients who underwent surgery for acute empyema at our hospital between July 2020 and July 2023. Based on pleural fluid cultures, patients were categorized into the following three groups: those with oral commensal bacteria (Group A), those with non-oral bacteria (Group B 1), and culture-negative cases (Group B2) . Oral health parameters were compared between groups.  \nResults: Of the 45 patients (mean age: 66.6 years; 38 males), 18 were classified as Group A, nine as Group B 1, and 18 as Group B2. Group B had a significantly higher smoking index than Group A. Compared with national dental health data, empyema patients exhibited markedly poorer oral hygiene, including a higher prevalence of periodontal disease and bleeding on probing (BOP) . The culture positivity rate was 40%, consistent with previous studies. Group B1 showed the longest hospital stays and the highest smoking index, while Group A had more treated teeth and lower tobacco exposure.  \nConclusion: Smoking was associated with empyema cases not linked to oral bacteria, suggesting it may act as a cofactor rather than an independent causal pathway. These findings support a dual-pathway hypothesis in which empyema may develop either through pneumonia induced by oral bacteria or through secondary infection in smokers. Further studies incorporating genetic and immunological analyses are warranted.  \nCategories: Dentistry, Oral Medicine  \nKeywords: empyema, national dental health data, oral commensal bacteria, oral health, smoking  \nIntroduction  \nEmpyema is characterized by the accumulation of pus in the pleural cavity [1] . Oral commensal bacteria have been identified as causative pathogens, with odontogenic infections recognized as a particularly important source [2,3] . Empyema frequently affects the elderly and those with compromised immune systems. Odontogenic infections reportedly cause many cases of acute empyema requiring surgical intervention. There are several known routes of empyema development, including progression from pneumonia or lung abscess, spread from other inflammatory sites, and secondary infection following invasive thoracic procedures, with pneumonia and lung abscess being the most common origins [4] . Although recent advances in antimicrobial chemotherapy have made the treatment of many bacterial infections easier, the mortality rate of empyema remains high at 3-12% even today [5] . In recent years, the incidence of empyema has reportedly increased, especially among older adults and immunosuppressed patients. Previous studies have also indicated that poor oral hygiene may contribute to r","cbCaioizdY2q8nuH","https://ap.wps.com/l/cbCaioizdY2q8nuH","pdf",159019,"English","# Abstract\n## Background and aim\n## Methods\n## Results\n## Conclusion\n# Introduction\n# Materials and Methods\n## How to cite this article","[{\"question\":\"What was the purpose of this study on acute empyema?\",\"answer\":\"The study evaluated oral health in acute empyema patients and explored whether oral bacteria or smoking status were associated with empyema development.\"},{\"question\":\"How were patients grouped in the methods?\",\"answer\":\"Patients were categorized based on pleural fluid cultures into three groups: oral commensal bacteria (Group A), non-oral bacteria (Group B1), and culture-negative cases (Group B2).\"},{\"question\":\"What did the study find about smoking and empyema?\",\"answer\":\"Group B showed a significantly higher smoking index than Group A, and smoking was associated with empyema cases not linked to oral bacteria, supporting a dual-pathway hypothesis.\"}]","Smoking as a Contributing Factor in the Development of Empyema | PDF",1790580488,18]