Parapneumonic Effusion

Question 1

Uncomplicated parapneumonic effusion

Answer 1

Etiology- movement of fluid from pneumonia into visceral pleura
Pleural fluid analysis- pH>7.20, normal or decreased glucose, LDH ratio>0.6
Pleural fluid Gram stain- Negative
Pleural fluid culture- Negative
Treatment- Antibiotics

Question 2

Complicated parapneumonic effusion

Answer 2

Etiology- Persistent bacterial invasion into pleural fluid
Pleural fluid analysis- pH<7.20, decorated glucose, LDH ratio>0.6
Pleural fluid Gram stain- Negative
Pleural fluid culture- Usually Negative
Treatment- Abx, usually requires chest tube for drainage

Question 3

Empyema

Answer 3

Etiology- bacterial colonization, purulent fluid
Pleural fluid analysis- pH<7.20, decreased glucose, LDH ration>0.6
Pleural fluid Gram stain- positive
Pleural fluid culture- Usually positive
Treatment- Abx + chest tube drainage