Pleural Infection (Respiratory)

Question 1

What are the risk factors for pleural infection?

Answer 1

Diabetes, immunosuppression including corticosteroids, gastro-oesophageal reflux, alcohol misuse, IV drug abuse.

Question 2

What are the signs of a complicated effusion?

Answer 2

+ve gram stain, pH <7.2, low glucose, septations (divide into compartments), loculations.

Question 3

What should be done to manage a pleural infection?

Answer 3

Antibiotics, drain, early discussion with surgeons if persistent sepsis, nutrition, VTE prophylaxis, role for fibrinolytics/DNAse maybe, reassess patients who don’t improve.