Chest
Clinical InvestigationsThe Incidence and Clinical Correlates of Parapneumonic Effusions in Pneumococcal Pneumonia
Section snippets
MATERIALS AND METHODS
All admissions to the medical service of a Veterans Administration Hospital for three months and a city-county hospital for the following three months were reviewed by one of us. The group under study was comprised of all patients with an acute clinical event, a new radiographic alveolar infiltrate, a sputum stain showing gram-positive diplococci, a culture of blood or sputum (or both) positive for Streptococcus pneumoniae, the absence of other pathogens in cultures of sputum, and an
RESULTS
Thirty-five patients comprised the group under study. There were 27 men and eight women, reflecting the population of the Veterans Administration Hospital. The mean age was 57 ± 3 years (± SE) (range, 22 to 89 years). Of the 35 patients, 20 (57 percent) had parapneumonic effusions. Nine of the 20 effusions were present on admission, and the remaining 11 developed variably between the second day and the sixth day of hospitalization. Sixteen of the 20 effusions were suspected on the
DISCUSSION
The incidence of parapneumonic effusions in parapneumococcal pneumonia was 57 percent (20/35). These effusions were associated with prolonged symptoms prior to admission, bacteremia, and persistent fever after therapy.
Although pleurisy is common,10 pleural effusions are claimed to be rare11, 12, 13 and are considered a complication of pneumococcal pneumonia.2 The increased incidence found in this series is not surprising, considering the pathogenesis of pneumococcal pneumonia, but may partially
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Cited by (131)
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2022, Radiologic Clinics of North AmericaCitation Excerpt :Centrilobular nodules, bronchial wall thickening, bilateral pleural effusions, cavitation, gangrene, and pneumatocele formation are unusual but when present suggest polymicrobial infection.39,40 Parapneumonic pleural effusions are not uncommon.41 Staphylococcus aureus are gram-positive, nonmotile, non–spore-forming, coagulase-producing facultative anaerobes that are cocci-shaped and arranged in clusters.
Pleural Infection
2021, Encyclopedia of Respiratory Medicine, Second EditionParapneumonic pleural effusions: Epidemiology, diagnosis, classification and management
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2013, Clinics in Chest MedicineCitation Excerpt :This seems to be the case for both children and adults, and although most data are derived from populations in the developed world, this pattern has been replicated worldwide.3,4,13–15 Between 20% and 57% of patients who develop pneumonia go on to develop a parapneumonic effusion,16–18 and although most of these patients do not require invasive treatment or investigation, a small subgroup may experience serious complications. Of the approximately 1 million cases of hospitalized pneumonia each year in the United States, around 60,000 develop frank empyema.
Intrapleural streptokinase for the treatment of complicated parapneumonic effusion and empyema in 2 newborns
2012, Journal of Pediatric Surgery
Presented in part at the scientific session of the American Thoracic Society, San Francisco, May 17, 1977.
From the Division of Pulmonary Sciences, Department of Medicine, University of Colorado Medical Center, Denver.
Manuscript received November 11; revision accepted January 23.