Para-pneumonic effusions

[iBS1972]

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What's the difference between a complicated para-pneumonic effusion and an empyema? Is it just that empyema has a lot more bacteria, and thus pus-like fluid?

 

[Raryn]

What's the difference between a complicated para-pneumonic effusion and an empyema? Is it just that empyema has a lot more bacteria, and thus pus-like fluid?

The terms are commonly misused, but you have them down right.

A complicated parapneumonic effusion is one with evidence of infection (+culture, gram stain, low pH, low glucose, whatever) that needs to be drained (chest tube placement). Sometimes if you have a loculated complicated parapneumonic effusion you can do chest tube + tpa/dna-ase to try to break it up, but that won't do anything with a true empyema.

An empyema is frank pus. It's not liquid, it's goo. Chest tube isn't enough, these require surgical treatment to get out of there.

 

[iBS1972]

Ah gotcha, thanks Raryn!