Parapneumonic pleural effusions and empyemas: a plea for early drainage

Parapneumonic effusions are relatively common sequelae of pneumonias. Occasionally, parapneumonic effusions will lead to empyemas. If these fluid collections are not aggressively drained in a timely manner, they will become loculated, placing the patient at risk for septic complications. Two cases of parapneumonic empyemas with delayed drainage eventually requiring thoracotomy and decortication are presented. These cases illustrate the need for early, complete drainage of parapneumonic empyemas to avoid septic complications and unnecessary surgery.