eMedicine Specialties > Pulmonology > Pleural Disorders

Parapneumonic Pleural Effusions and Empyema Thoracis: Multimedia

Author: Atikun Limsukon, MD, Instructor, Department of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Thailand
Coauthor(s): Guy W Soo Hoo, MD, MPH, Clinical Professor of Medicine, Geffen School of Medicine at the University of California at Los Angeles; Director, Medical Intensive Care Unit, Pulmonary and Critical Care Section, West Los Angeles Healthcare Center, Veteran Affairs Greater Los Angeles Healthcare System
Contributor Information and Disclosures

Updated: Sep 17, 2009

Multimedia

Left pleural effusion developed 4 days after anti...
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Media file 1: Left pleural effusion developed 4 days after antibiotic treatment for pneumococcal pneumonia. Patient developed fever, left-sided chest pain, and increasing dyspnea. During thoracentesis, purulent pleural fluid was removed, and the Gram stain showed gram-positive diplococci. The culture confirmed this to be Streptococcus pneumoniae.
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Left pleural effusion developed 4 days after anti...

Left pleural effusion developed 4 days after antibiotic treatment for pneumococcal pneumonia. Patient developed fever, left-sided chest pain, and increasing dyspnea. During thoracentesis, purulent pleural fluid was removed, and the Gram stain showed gram-positive diplococci. The culture confirmed this to be Streptococcus pneumoniae.

Left lateral chest radiograph shows a large, left...
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Media file 2: Left lateral chest radiograph shows a large, left pleural effusion.
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Left lateral chest radiograph shows a large, left...

Left lateral chest radiograph shows a large, left pleural effusion.

A right lateral decubitus chest radiograph shows ...
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Media file 3: A right lateral decubitus chest radiograph shows a free-flowing pleural effusion, which should be sampled with thoracentesis for pH determination, Gram stain, and culture.
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A right lateral decubitus chest radiograph shows ...

A right lateral decubitus chest radiograph shows a free-flowing pleural effusion, which should be sampled with thoracentesis for pH determination, Gram stain, and culture.

CT scan of thorax shows loculated pleural effusio...
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Media file 4: CT scan of thorax shows loculated pleural effusion on left and contrast enhancement of visceral pleura, indicating the etiology is likely an empyema.
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CT scan of thorax shows loculated pleural effusio...

CT scan of thorax shows loculated pleural effusion on left and contrast enhancement of visceral pleura, indicating the etiology is likely an empyema.

Chest CT scan with intravenous contrast in a pati...
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Media file 5: Chest CT scan with intravenous contrast in a patient with mixed Staphylococcus milleri and anaerobic empyema following aspiration pneumonia, showing a thickened contrast-enhanced pleural rind, high-density pleural effusion, loculation, and septation. Thoracentesis yielded foul-smelling pus.
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Chest CT scan with intravenous contrast in a pati...

Chest CT scan with intravenous contrast in a patient with mixed Staphylococcus milleri and anaerobic empyema following aspiration pneumonia, showing a thickened contrast-enhanced pleural rind, high-density pleural effusion, loculation, and septation. Thoracentesis yielded foul-smelling pus.

Chest CT scan of the same patient in Media File 5...
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Media file 6: Chest CT scan of the same patient in Media File 5, three days following thoracostomy and intrapleural fibrinolysis(reteplase).
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Chest CT scan of the same patient in Media File 5...

Chest CT scan of the same patient in Media File 5, three days following thoracostomy and intrapleural fibrinolysis(reteplase).

More on Parapneumonic Pleural Effusions and Empyema Thoracis

Overview: Parapneumonic Pleural Effusions and Empyema Thoracis
Differential Diagnoses & Workup: Parapneumonic Pleural Effusions and Empyema Thoracis
Treatment & Medication: Parapneumonic Pleural Effusions and Empyema Thoracis
Follow-up: Parapneumonic Pleural Effusions and Empyema Thoracis
Multimedia: Parapneumonic Pleural Effusions and Empyema Thoracis
References
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References

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Further Reading

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Keywords

empyema thoracis, pleural effusions, pleural effusion, parapneumonic pleural effusion, pleuropulmonary empyema, complicated parapneumonic pleural effusion, uncomplicated parapneumonic effusion, thoracic empyema, thoracoplasty, decortication, pneumonia, parapneumonic effusion, esophageal perforation, trauma, surgical procedure on pleural space, septicemia

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Contributor Information and Disclosures

Author

Atikun Limsukon, MD, Instructor, Department of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Thailand
Atikun Limsukon, MD is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, and California Thoracic Society
Disclosure: Nothing to disclose.

Coauthor(s)

Guy W Soo Hoo, MD, MPH, Clinical Professor of Medicine, Geffen School of Medicine at the University of California at Los Angeles; Director, Medical Intensive Care Unit, Pulmonary and Critical Care Section, West Los Angeles Healthcare Center, Veteran Affairs Greater Los Angeles Healthcare System
Guy W Soo Hoo, MD, MPH is a member of the following medical societies: American Association for Respiratory Care, American College of Chest Physicians, American College of Physicians, American Thoracic Society, California Thoracic Society, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Medical Editor

Michael Peterson, MD, Chief of Medicine, Vice-Chair of Medicine, University of California at San Francisco; Endowed Professor of Medicine, University of California at San Francisco-Fresno
Michael Peterson, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H, Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine
Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine
Disclosure: Keck School of Medicine, USC None None

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center; Professor of Medicine, David Geffen School of Medicine at UCLA
Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society
Disclosure: Nothing to disclose.

 
 
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