Pleural effusions caused by infection

Postgraduate Medicine
B Varkey

Abstract

Diagnostic thoracentesis is imperative when pneumonia is accompanied by an effusion (parapneumonic effusion). Examination of the pleural fluid is the only way to differentiate empyema and complicated parapneumonic effusions from uncomplicated parapneumonic effusions, and this differentiation is vital in deciding whether chest tube drainage is needed. If the aspirated pleural fluid contains pus or bacteria, closed chest tube drainage and antibiotic therapy should be started promptly. The same management approach is indicated if the pleural fluid pH is less than 7.00 or the glucose level is less than 40 mg/ml, since these effusions almost invariably are complicated parapneumonic effusions that do not resolve without fluid drainage. If the pleural fluid pH is greater than 7.20 and glucose level is more than 40 mg/ml, antibiotic therapy alone will suffice. Management of parapneumonic effusions with a pH of 7.00 to 7.20 should be based on serial observations of clinical status and pleural fluid findings.

References

Aug 1, 1975·Chest·R W LightR B George
Mar 2, 1974·Lancet·J G BartlettS M Finegold
Feb 1, 1968·Annals of Internal Medicine·J R Tillotson, A M Lerner
Nov 1, 1973·Chest·R W LightP C Luchsinger
Jul 20, 1967·The New England Journal of Medicine·J R Tillotson, A M Lerner
Oct 1, 1980·The American Journal of Medicine·R W LightR B George
Sep 6, 1958·Journal of the American Medical Association·W H HENDREN, R J HAGGERTY

❮ Previous
Next ❯

Related Concepts

Related Feeds

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.

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.

Related Papers

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Steve A Sahn
© 2021 Meta ULC. All rights reserved