Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics

Abstract

A novel CT scoring system for adults with PPE may allow clinicians to predict the need for chest tube drainage with good accuracy.

CT versus thoracic ultrasound for discriminating uncomplicated and complicated parapneumonic pleural effusions

“…I appreciate the interest of Dr. Varsamas et al in our article 1 and their comments. I agree with the potential advantages of transthoracic ultrasound (TUS) over computed tomography (CT) in the management of parapneumonic effusions (PPE); namely, a higher sensitivity for detecting pleural fluid septations, lower cost, avoidance of exposure to ionizing radiation and performance at the bedside.…”

Year in review 2017: Interventional pulmonology, lung cancer, pleural disease and respiratory infections

“…Given the advent of—and advances in—antimicrobial therapy, it is worth pondering over whether the dictum of ‘the sun should never set on a parapneumonic effusion’ still holds weight. Findings from a retrospective study of 150 patients with a clinical diagnosis of parapneumonic effusion revealed that not only do many such patients never get chest tube drainage as part of real‐world practice (including some with frank pus on thoracentesis), but also many of these remain clinically well with resolution of the infection using antibiotics alone . A thought‐provoking accompanying editorial draws parallels between this approach and the current standard of care for spontaneous bacterial peritonitis and abscesses of the lung and liver, which are often treated successfully with systemic therapy alone .…”

Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

“…Parapneumonic effusion (PPE) is an accumulation of exudative pleural fluid that occurs in association with an ipsilateral pulmonary infection, mainly pneumonia, and may also accompany lung abscess and infected bronchiectasis. PPEs are the most common exudative pleural effusions, and are present in 20% to 54% of patients with bacterial pneumonia [ 1 , 2 ]. Based on the characteristics of a diagnostic thoracentesis, PPE can be classified into uncomplicated PPE (UCPPE), or complicated PPE (CPPE).…”

“…The minority (about 30%) are CPPEs that follow a complicated course requiring, in addition to antibiotic treatment, more aggressive intervention, such as chest tube thoracostomy or pleural space decortication. Patients with CPPE have a significantly higher morbidity and mortality rate [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”