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Semin Respir Crit Care Med 2001; 22(6): 591-606
DOI: 10.1055/s-2001-18795
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Parapneumonic Effusions and Empyema

John E. Heffner1 , Jeffrey Klein2
  • 1Medical University of South Carolina, Charleston, South Carolina
  • 2University of Vermont College of Medicine, Burlington, Vermont
Further Information

Publication History

Publication Date:
05 December 2001 (online)

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ABSTRACT

Parapneumonic effusions occur in up to 60% of patients hospitalized with community acquired pneumonia. Fortunately, the majority of these effusions follow an uncomplicated course responding to antibiotic therapy alone. An important subgroup of patients, however, follow a complicated course progressing to an empyema unless infected pleural fluid is drained. Decisions for drainage depend on host factors, the nature of the respiratory pathogen, and the extent of pleural inflammation and loculation. Staging of a parapneumonic effusion allows selection of a drainage procedure that will be most effective. Adjunctive therapies, such as intrapleural fibrinolysis, appear to contribute to resolution of pleural infection but more investigational data are needed to determine their specific role.

KEYWORD

Empyema - pneumonia - parapneumonia effusion - pleural infection

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