Related Experiment Video
Updated: May 21, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
[Pleural empyema and lung abscess: current treatment options]
E Hecker1, S Hamouri, E Müller
1Thoraxzentrum Ruhrgebiet, Klinik für Thoraxchirurgie, Herne, Deutschland. e.hecker@evk-herne.de
Zentralblatt Fur Chirurgie
|June 20, 2012
Summary
This study reviews classifications and treatments for parapneumonic pleural empyema and lung abscesses. Management strategies range from antibiotics to surgery, tailored to disease stage and patient risk.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Infectious Diseases
Context:
- Parapneumonic pleural empyema is classified by the American Thoracic Society (ATS), Light, and American College of Chest Physicians (ACCP) based on disease course, characteristics, and patient risk.
- Lung abscesses can be primary, aspiration-related, community-acquired, nosocomial, or occur in immunosuppressed individuals.
Purpose:
- To outline the staging and classification systems for parapneumonic pleural empyema.
- To describe therapeutic strategies for pleural empyema, including chest tubes, fibrinolysis, thoracoscopic debridement, and decortication.
- To discuss the management of lung abscesses, emphasizing antibiotic treatment and interventional options.
Summary:
- Pleural empyema management is guided by ATS, Light, and ACCP classifications, involving interventions like chest tubes and surgery.
- Most lung abscesses (90%) resolve with antibiotics; 10% require interventions like catheters or chest tubes, with only 1% needing surgery.
Impact:
- Provides a comprehensive overview of current diagnostic and therapeutic approaches for pleural empyema and lung abscesses.
- Highlights the importance of risk stratification and staging in guiding treatment decisions for better patient outcomes.
- Informs clinicians on the spectrum of interventions required, from conservative antibiotic therapy to advanced surgical procedures.
Related Concept Videos
01:28Pleural Effusion II: Symptoms and Management
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:30Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...