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When microorganisms infect the pleural space, a complicated parapneumonic effusion or empyema may result. Prompt therapy of these entities can be lifesaving. The treatment and prognosis of parapneumonic effusion and empyema are reviewed here.
Parapneumonic effusion – Pleural effusion associated with lung infection (ie, pneumonia). Early in the disease course, the effusion usually is free-flowing (also known as a "simple" effusion) and sterile.
In paramalignant pleural effusions, pleural fluid cytology and pleural biopsy are negative because cancer cells have not invaded pleural membranes. Paramalignant effusions are managed according to the underlying etiology. TREATMENT GOALS
Diagnostic (new effusion of unclear etiology) – Most patients who have a newly detected pleural effusion of unclear etiology should undergo diagnostic thoracentesis to determine the nature of the pleural effusion (ie, transudate, exudate) and to identify potential causes.
Diagnostic evaluation of the hemodynamically stable adult with a pleural effusion; Diagnostic evaluation of the incidental pulmonary nodule; Drug-induced lung disease in rheumatoid arthritis; Epidemiology, clinical presentation, and diagnostic evaluation of parapneumonic effusion and empyema in adults; Etiology and pathogenesis of rheumatoid ...
Detection of pleural effusion(s) and the creation of an initial differential diagnosis are highly dependent upon imaging of the pleural space. Conventional chest radiography and computed tomography (CT) scanning are the primary imaging modalities that are used for evaluation of all types of pleural disease, but ultrasound and magnetic resonance ...
Patient education: Pleural effusion (The Basics) Pleural fluid analysis in adults with a pleural effusion; Pulmonary manifestations of systemic lupus erythematosus in adults; Selection of modality for diagnosis and staging of patients with suspected non-small cell lung cancer
In this review, we discuss the prevalence, etiology, evaluation, and management of patients who present with a pleural effusion after cardiac surgery. Initial evaluation of a pleural effusion in non-surgical setting is discussed separately. (See "Pleural fluid analysis in adults with a pleural effusion".) PREVALENCE
Parapneumonic effusion is defined as pleural effusion associated with lung infection (ie, pneumonia). Early in the disease course, the effusion usually is free-flowing (also known as a "simple" effusion) and sterile.
Loculated effusions, large free-flowing effusions (eg, ≥0.5 hemithorax), and effusions with a thickened pleural membrane should also be drained. When the collection is free-flowing, a single tube or catheter thoracostomy is the procedure of choice.