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Pleural Infection in Adults: Integrating Medical and Surgical Management for Optimal Outcomes

Malvika Bhatnagar1, Gian-Marco Monsch2, Stefano Kette3

  • 1Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.

Thoracic Surgery Clinics
|June 23, 2026
PubMed

Insights

Pleural infection management requires early diagnosis and structured reassessment. An integrated physician-surgeon approach is essential for optimal outcomes and preventing advanced empyema.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Pleural infection significantly contributes to patient morbidity and mortality.
  • Current management is often hindered by delayed diagnosis and disease heterogeneity.

Purpose of the Study:

  • To integrate medical and surgical insights for optimizing pleural infection management.
  • To emphasize early diagnosis, reassessment, and multidisciplinary decision-making.

Main Methods:

  • Review of contemporary medical and surgical perspectives on pleural infection.
  • Discussion of treatment modalities including antibiotics, chest tube drainage, intrapleural enzymes, and surgery.
  • Highlighting evidence-based criteria for treatment escalation.

Main Results:

  • Delayed diagnosis and treatment uncertainty complicate pleural infection management.
  • An integrated physician-surgeon approach is crucial for effective management.

Conclusions:

  • Early diagnosis and structured reassessment are key to improving pleural infection outcomes.
  • Timely, multidisciplinary decision-making prevents progression to advanced empyema.
Keywords:
DecorticationEmpyemaIntrapleural enzyme therapyMultidisciplinary managementParapneumonic effusionPleural infectionVideo-assisted thoracoscopic surgery

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