• Madalina Macrea and Mark L Metersky.
• Salem VA Medical Center, Virginia, USA.
• Conn Med. 2006 Jun 1;70(6):371-5.

BackgroundThere are little data regarding the outcomes of parapneumonic pleural effusions that first appear during antibiotic treatment of the underlying pneumonia.ObjectivesTo assess the outcome of patients who develop a parapneumonic effusion while on antibiotic therapy.MethodsPatients admitted to the John Dempsey Hospital with a discharge diagnosis of pneumonia were identified retrospectively. Patients with minimal or no effusion on admission chest radiograph who subsequently developed a parapneumonic effusion during their hospital stay were included. The characteristics of the effusions and the patient outcomes were studied.ResultsTwenty-eight (3%) of 1,028 patients developed a parapneumonic effusion while in the hospital. Seventy-one percent of the parapneumonic effusions were small (occupying less than one-third of the hemithorax) and 29% were moderate (occupying between one-third and two-thirds of the hemithorax). No patients required tube thoracostomy or other drainage procedure.ConclusionPatients with pneumonia who develop a parapneumonic effusion while receiving antibiotic therapy are unlikely to develop empyema or a complicated effusion requiring drainage.

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