PMID: 11913110Mar 27, 2002Paper

Pleural effusion and empyema as complications of pneumonia

Nederlands tijdschrift voor geneeskunde
A M M BauwensW G Boersma

Abstract

Parapneumonic effusion is observed radiologically in approximately 40% of the patients with a bacterial pneumonia. In most cases the course of the disease is uncomplicated, and the parapneumonic effusion (PPE) resolves with antibiotic therapy. However, in 5-10% of the patients, PPE becomes more complicated (loculation) and the effusion eventually leads to the formation of an empyema if no drainage has been performed. In view of negative impact on morbidity and mortality, it is important to recognise and evaluate a PPE as soon as possible. Intrapleural pus is the only absolute indication for drainage. In all other cases, the risk of a complicated PPE has to be established in the early phase of the illness, based on radiological, biochemical and microbiological parameters of the effusion. Based on these findings one or more of the following therapeutic strategies can be chosen: tube installation with drainage, fibrinolytical therapy, video-assisted thoracoscopic surgery, thoracotomy with or without decortication, or open drainage. Although every PPE needs to be evaluated on an individual basis, an attempt has been made to formulate a strategy that can be used in clinical practice, based on recent literature and expert opinions.

Related Concepts

Related Feeds

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.