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Management of Empyema

  • Shannon R. Kotch
  • Matthew D. TaylorEmail author
Chapter

Abstract

Pleural effusions are commonly associated with pneumonia; however, progression to empyema can occur. The fluid must be sampled if there is concern for empyema. A tube thoracostomy should be placed to drain the fluid; if the collection persists despite drainage, fibrinolytics can be instilled through the tube, or, in certain circumstances, the patient may proceed directly to surgical intervention.

Keywords

Parapneumonic effusion Empyema Thoracentesis Fibrinolytic Decortication VATS 

References

  1. 1.
    Raymond D. Surgical intervention for thoracic infections. Surg Clin North Am. 2014;94(6):1283–303.  https://doi.org/10.1016/j.suc.2014.08.004.CrossRefPubMedGoogle Scholar
  2. 2.
    Bhatnagar R, Maskell NA. Treatment of complicated pleural effusions in 2013. Clin Chest Med. 2013;34(1):47–62.  https://doi.org/10.1016/j.ccm.2012.11.004.CrossRefPubMedGoogle Scholar
  3. 3.
    Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, Peckham D, Davies CW, Ali N, Kinnear W, Bentley A, Kahan BC, Wrightson JM, Davies HE, Hooper CE, Lee YC, Hedley EL, Crosthwaite N, Choo L, Helm EJ, Gleeson FV, Nunn AJ, Davies RJ. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011;365(6):518–26.  https://doi.org/10.1056/NEJMoa1012740.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of General SurgeryPenn State Health Milton S. Hershey Medical CenterHersheyUSA
  2. 2.Department of SurgeryPenn State Health Milton S. Hershey Medical CenterHersheyUSA
  3. 3.Division of Thoracic SurgeryPenn State Health Milton S. Hershey Medical CenterHersheyUSA

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