Diagnosis and Treatment of Complicated Pleural Effusion

Kim, Seok Chan

Abstract

Parapneumonic effusion is pleural effusion that arises in the pleural space, complicated with bacterial pneumonia. This occurs in at least forty percent of bacterial pneumonia. The usual parapneumonic effusion resolves well with antibiotic therapy. However, if bacteria invade the pleural space, a complicated parapneumonic effusion or empyema may result. In addition to appropriate antibiotic therapy, some parapneumonic effusions and empyemas need additional treatment, such as drainage procedures. The necessity of drainage for treatment of parapneumonic effusions depends on the several types or stages of parapneumonic effusion. Empyemas may need additional intervention beyond simple chest tube drainage, including placement of additional drainage tubes under fluoroscopy, video-assisted thoracoscopy with lysis of adhesions, and decortication. Patients with persistent air leaks often require surgical or endoscopic repair procedures.