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Pleural infection and empyema

Yong Soo Kwon1

  • 1Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

Tuberculosis and Respiratory Diseases
|May 23, 2014
PubMed

Insights

Pleural infection incidence is rising globally, with evolving pathogens. New treatments combining tissue plasminogen activator and deoxyribonuclease show promise, alongside antibiotics and drainage for effective pleural infection management.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • Rising global incidence of pleural infection reported in recent decades.
  • Pathogen profiles for pleural infection are shifting and distinct from community-acquired pneumonia.
  • Current primary treatments include antibiotics and pleural fluid drainage.

Purpose of the Study:

  • To review current understanding and treatment strategies for pleural infection.
  • To evaluate the efficacy of intrapleural fibrinolytics, particularly novel combinations.
  • To highlight the role of surgical drainage in severe or refractory cases.

Main Methods:

  • Literature review of recent studies on pleural infection.
  • Analysis of treatment outcomes for antibiotics, drainage, and intrapleural therapies.
  • Examination of a specific randomized controlled study on tissue plasminogen activator and deoxyribonuclease.

Main Results:

  • Efficacy of intrapleural fibrinolytics is not fully established.
  • A recent study demonstrated improved outcomes with a combination of tissue plasminogen activator and deoxyribonuclease.
  • Surgical drainage remains crucial for sepsis progression and treatment failure with tube drainage.

Conclusions:

  • Pleural infection management requires tailored approaches considering evolving pathogens.
  • Novel intrapleural therapies show potential for improved clinical outcomes.
  • Prompt and appropriate drainage, including surgical intervention, is vital for severe cases.
Keywords:
DrainageEmpyemaEtiologyFibrinolytic Agents

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