Parapneumonic effusion – clinical approach NEETPG MCQ

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  • Pleural effusions are commonly associated with pneumo- nia and should be assessed via thoracentesis to determine whether the pleural fluid is also infected. A viscous, infected pleural fluid can become organized following pneumonia, resulting in development of empyema or chronic pleural effusion with trapped lung that is unable to reexpand.
  • In order to prevent these complications, it is recommended that all pleural effusions separated from the chest wall by >10 mm undergo thoracentesis.
  • Characteristics that predict increased likelihood of complications with a parapneumonic effusion include: loculated pleural fluid, pleural fluid pH <7.20, pleural fluid glucose <60 mg/dL, positive Gram stain or culture of the pleural fluid, and presence of frank pus (em- pyema) of the pleural space.
  • Individuals whose pleural fluid has any of these characteristics should be considered for tube thoracostomy drainage of the pleural fluid.

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