Parapneumonic Effusion and Empyema

Dinesh N Addala; Eihab O Bedawi; Najib M Rahman

doi:10.1016/j.ccm.2021.08.001

Parapneumonic Effusion and Empyema

Clin Chest Med. 2021 Dec;42(4):637-647. doi: 10.1016/j.ccm.2021.08.001.

Authors

Dinesh N Addala¹, Eihab O Bedawi², Najib M Rahman³

Affiliations

¹ Oxford University Hospitals NHS Foundation Trust; Department of Respiratory Medicine, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK. Electronic address: dnaddala@gmail.com.
² Oxford University Hospitals NHS Foundation Trust; Department of Respiratory Medicine, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK.
³ Oxford University Hospitals NHS Foundation Trust; Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, Headington OX3 9DU, UK.

PMID: 34774171
DOI: 10.1016/j.ccm.2021.08.001

Abstract

The rising incidence and high morbidity of pleural infection remain a significant challenge to health care systems worldwide. With distinct microbiology and treatment paradigms from pneumonia, pleural infection is an area in which the evidence base has been rapidly evolving. Progress in recent years has revolved around characterizing the microbiome of pleural infection and the addition of new strategies such as intrapleural enzyme therapy to the established treatment pathway of drainage and antibiotics. The future of improving outcomes lies with personalizing treatment, establishing optimal timing of intrapleural agents and surgery, alongside wider use of risk stratification to guide treatment.

Keywords: Empyema; Parapneumonic effusion; Pleural infection.

Publication types

Review

MeSH terms

Empyema, Pleural* / diagnosis
Empyema, Pleural* / epidemiology
Empyema, Pleural* / etiology
Fibrinolytic Agents / therapeutic use
Humans
Pleural Effusion* / diagnosis
Pleural Effusion* / etiology
Pleural Effusion* / therapy
Pneumonia* / drug therapy
Thrombolytic Therapy

Substances

Fibrinolytic Agents