![]() GENERAL APPROACH TO MANAGEMENT - The management of parapneumonic effusions and empyema generally includes prompt antibiotic initiation and drainage of infected pleural fluid. ![]() A uniloculated effusion is one where the effusion is without internal septae (it is not necessarily free-flowing).A complex effusion refers to an effusion with internal loculations (septae).While a complicated parapneumonic effusion and empyema represent a spectrum of infection within the pleural space, no pus is directly visualized in patients with a complicated parapneumonic effusion. Empyema that develops from an adjacent pneumonia is a subclass of a complicated parapneumonic effusion. An empyema refers to a collection of pus within the pleural space, which can develop when pyogenic bacteria invade the pleural space, from an adjacent pneumonia, direct inoculation (eg, from blunt trauma) or other source.(See "Epidemiology, clinical presentation, and diagnostic evaluation of parapneumonic effusion and empyema in adults", section on 'Complicated parapneumonic effusion and empyema'.) A complicated parapneumonic effusion refers to an effusion that has been infected with bacteria or other microorganisms (eg, positive Gram stain or biochemical evidence of marked inflammation).An uncomplicated or simple parapneumonic effusion refers to a free-flowing effusion that is sterile.(See "Epidemiology, clinical presentation, and diagnostic evaluation of parapneumonic effusion and empyema in adults" and "Epidemiology, clinical presentation, and evaluation of parapneumonic effusion and empyema in children" and "Management and prognosis of parapneumonic effusion and empyema in children".)ĭEFINITIONS - A parapneumonic effusion refers to the accumulation of fluid in the pleural space in the setting of an adjacent pneumonia. The clinical diagnosis of parapneumonic effusion and empyema in adults and management in children are discussed separately. The treatment and prognosis of parapneumonic effusion and empyema are reviewed here. Prompt therapy of these entities can be lifesaving. ![]() When microorganisms infect the pleural space, a complicated parapneumonic effusion or empyema may result. INTRODUCTION - A parapneumonic effusion is a pleural effusion that forms in the pleural space adjacent to a pneumonia. ![]()
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