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Parapneumonic effusion is a common clinical problem, and those that go on to develop pleural infection have high morbidity and mortality. The process of pleural infection evolution involves changes in pleural physiology that are increasingly being elucidated and understood. The microbiology of pleural infection has changed over recent years, with clear differences emerging between hospital- and community-acquired infections. Using biochemical surrogates of infection, chest drainage can be undertaken rationally for those who do not respond to antibiotics alone. Recent data suggest that fibrinolytics do not influence outcomes in pleural infection. The optimal type and timing of surgery remain controversial.

Original publication

DOI

10.1016/j.ccm.2005.12.005

Type

Journal article

Journal

Clin Chest Med

Publication Date

06/2006

Volume

27

Pages

253 - 266

Keywords

Community-Acquired Infections, Diagnosis, Differential, Drainage, Empyema, Pleural, Humans, Pleural Effusion, Thoracic Surgery, Video-Assisted, Thrombolytic Therapy