Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 11-12, Pages: 680-687
https://doi.org/10.2298/SARH1412680D
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Parapneumonic effusions: Features, diagnostics and treatment options
Đurić Mirna (Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica)
Đurić Dejan (Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica)
Ćulibrk Tamara (Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica)
Považan Đorđe (Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica)
Introduction. Parapneumonic effusions, as a complication of inflammatory
processes in the lungs, usually have a good course, but they sometimes
progress into pulmonary empyema, thus becoming a significant clinical
problem. Objective. To review clinical and radiological features, as well as
diagnostic and therapeutic options in parapneumonic effusions. Methods. The
analysis included 130 patients with parapneumonic effusions hospitalized at
the General Pulmonology Clinic of the Institute for Pulmonary Diseases of
Vojvodina, Sremska Kamenica during 2013. Results. Of 385 patients with
pneumonia, 130 (33.8%) had parapneumonic effusion, 78 (60.0%) of whom were
males. Most patients (36l; 27.7%) were 60-69 years of age. The most common
symptoms included fever (92; 70.8%) and cough (91; 70.0%). Hypertension was
the most common comorbidity registered in 81 (62.3%) patients, and chronic
obstructive pulmonary disease present in 33 (25.4%) patients. Pleural
puncture was performed in 62 (47.7%) patients. Macroscopically, effusion was
clear in most cases (31; 50.0%), and cytologically the mixed type was most
frequently established (26; 41.9%). Bronchoscopy was performed in 52 (40.0%)
patients, and video-assisted thoracoscopy in 9 (6.9%) patients. Empyema signs
were registered in 13 (10.0%) patients; in all a thoracic drainage with
administration of intrapleural streptokinase was performed. Conclusion.
Patients with a parapneumonic effusion have the symptoms of acute respiratory
infection and frequent concomitant diseases. Further diagnostic and
therapeutic treatment depends on pleural fluid features and chest CT finding.
Keywords: parapneumonic effusion, pleural empyema, diagnosis, therapy