Key result
This review highlights the prognostic implications of pleural effusion in pneumonia, a potential role for corticosteroids in children, and ongoing optimization of intrapleural therapies.
This review highlights emerging concepts in the pathogenesis and treatment of pleural infection, including potential roles for corticosteroids and optimized intrapleural therapies.
Should not yet change practice in pleural infection; leaves open corticosteroid roles in children and optimized intrapleural regimens for trials.
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications. Over-exaggerated pleural inflammation may underlie development of parapneumonic effusion as indirect evidence and a randomized study in children raised a role of corticosteroids in parapneumonic pleural effusions, but data are lacking for adults. Optimization of the delivery regimen of intrapleural fibrinolytic and deoxyribonuclease therapy is ongoing. SUMMARY: The review aims to review the current practice and explore new directions of treatment on pleural infection.
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Chan et al. (2018) conducted a review in Pleural infection. This review highlights the prognostic implications of pleural effusion in pneumonia, a potential role for corticosteroids in children, and ongoing optimization of intrapleural therapies.
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