scholarly journals Features of Parapneumonic Effusions

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 131-141 ◽  
Author(s):  
Sanja Petrusevska Marinkovic ◽  
Irena Kondova Topuzovska ◽  
Milena Stevanovic ◽  
Ankica Anastasovska
Keyword(s):  
Pleural Fluid ◽  
Clinical Problem ◽  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Pleuritic Chest Pain ◽  
Radiological Features ◽  
Significant Difference ◽  
Costophrenic Angle ◽  
The University ◽  
Complicated Parapneumonic Effusion

Abstract Introduction: Parapneumonic effusions, as a complication of community-acquired pneumonia (CAP), usually have a good course, but they sometimes progress into complicated parapneumonic effusion (CPPE) and empyema, thus becoming a significant clinical problem. Aim: To review clinical and radiological features, as well as diagnostic and therapeutic options in parapneumonic effusions. Material and methods: The analysis included 94 patients with parapneumonic effusion hospitalized at the University Infectious Diseases Clinic in Skopje during a 4 year period. Out of 755 patients with CAP, 175 (23.18%), had parapneumonic effusion. Thoracentesis was performed in 94 (53.71%) patients, 50 patients were with uncomplicated parapneumonic effusions (UCPPE) and 44 with complicated parapneumonic effusions (CPPE). Results: More patients (59.57%) were male; the average age was 53.82±17.5 years. The most common symptoms included: fever (91; 96.81%), cough (80; 85.11%), pleuritic chest pain (68; 72.34%), dyspnea (65; 69.15%). Alcoholism was the most common comorbidity registered in 12 (12.77%) patients. Macroscopically, effusion was yellow and clear in most cases (36; 38.29%). Localization of pleural effusion was often in the left costophrenic angle (53; 56.38%) and ultrasonographic non-septated complex. Between the two groups of effusions there was a significant difference between the ERS, WBC and CRP in serum and CRP in pleural fluid. Statistical difference existed in terms of days of hospitalization with a longer hospital stay for patients with CPPE (p <0.0001). Conclusion: Patients with parapneumonic effusion have the symptoms of acute respiratory infection and frequent accompanying diseases. Future diagnostic and therapeutic treatment depends on pleural fluid features and imaging lung findings.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

scholarly journals Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia

Thorax ◽  
2009 ◽  
Vol 64 (7) ◽  
pp. 592-597 ◽  
Author(s):  
J D Chalmers ◽  
A Singanayagam ◽  
M P Murray ◽  
C Scally ◽  
A Fawzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Complicated Parapneumonic Effusion

Predictors of prolonged stay in patients with community-acquired pneumonia and complicated parapneumonic effusion

Respirology ◽  
2015 ◽  
Vol 21 (1) ◽  
pp. 164-171 ◽  
Author(s):  
Junghyun Kim ◽  
Jong Sun Park ◽  
Young-Jae Cho ◽  
Ho Il Yoon ◽  
Jae Ho Lee ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Prolonged Stay ◽  
Complicated Parapneumonic Effusion

scholarly journals Comparative analysis of the effectiveness of narrow-spectrum versus broad-spectrum antibiotics for the treatment of childhood pneumonia

2021 ◽  
Vol 9 ◽  
pp. 205031212110443
Author(s):  
Chilot Abiyu Demeke ◽  
Getnet Mequanent Adinew ◽  
Tamrat Befekadu Abebe ◽  
Abebech Tewabe Gelaye ◽  
Sisay G/Hana Gemeda ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Statistical Significance ◽  
Community Acquired Pneumonia ◽  
Referral Hospital ◽  
P Value ◽  
Data Set ◽  
Treatment Regimens ◽  
Narrow Spectrum ◽  
Significant Difference ◽  
The University

Objectives: The main objective of this study was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalized with community-acquired pneumonia (CAP) at the University of Gondar Referral Hospital, Gondar, Ethiopia. Methods: Institutional-based retrospective chart review was conducted at the University of Gondar Referral Hospital (GURH) pediatrics ward from 1 February 2016 to 30 April 2016. The collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were done to present the basic features and summary of the data set. In addition, binary logistics and multivariable logistic regression analysis were conducted to test for an association between the dependent and independent variables. A P value of <0.05 was taken to declare statistical significance at a 95% confidence interval. Result: A total of 147 patients with CAP were included in the study. Seven different treatment regimens were employed for the 147 children hospitalized. About 63 (42.9%) of the study participants received a narrow-spectrum antibiotic and 84 (57.1%) received a broad-spectrum antibiotic. There was no significant difference between the broad and narrow spectrum treatment groups in main treatment outcomes. The median length of stay (LOS) for the study population was 3 days. The median LOS was shorter among those receiving narrow-spectrum therapy compared with those receiving broad-spectrum therapy. Treatment dose and duration of therapy were significantly associated with treatment outcome (P < 0.0001 and P = 0.003), respectively. Conclusion: The effectiveness of narrow-spectrum therapy is similar to that of broad-spectrum therapy for children hospitalized with CAP. Treatment regimens for children with community-acquired pneumonia should be selected based on their safety profile and their tendency for antibiotic resistance.

scholarly journals Frequency and Types of Parapneumonic Effusion in Pleural Fluid Specimen

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Sajjad ◽  
Naseeb ur Rehman Shah ◽  
Sami Ullah Khan ◽  
Asim Muhammad ◽  
Shabir Hussain ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Ph Value ◽  
Culture Media ◽  
Community Acquired Pneumonia ◽  
Medical Laboratory ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Public And Private ◽  
Laboratory Parameters ◽  
Different Types

Background: Parapneumonic effusion (PPE) is exudative pleural effusion resulting from community acquired pneumonia or lungabscess. In USA about one million people develop PPE annually. The better outcome of PPE depends on early diagnosis andtimely management.Objective: The aim of this study was to see the frequency and types of parapneumonic effusion in pleural fluid specimen usingdifferent laboratory parameters in pneumonia patients.Material and Methods: This study was conducted in Shah Noor Medical laboratory in Bannu KPK. Pakistan. Pleural fluidspecimen were collected from both public and private sectors hospitals of the territory. A total of 422 pleural effusions werecollected. These fluid were analysed for transudate, exudate with possible causes. The PPE were subtyped into simple,complicated and empyema on the basis of color, PH value, ratio of blood and fluid glucose level, total protein level, total anddifferential leukocyte count of fluid, Gram's stain and culture for presence or absence of bacteria. The pleural fluid color wasexamined for subjective grades of turbidity i.e. mild, moderate and marked for simple, complicated and empyema respectively. PHcut off value was 7.2 for simple and complicated PPE, glucose cut off value of 52mg/dl for simple and complicated PPE. Gram'sstain and culture was performed by using conventional Gram's stain and different culture media for differention of simple fromcomplicated PPE and emyema. Inclusion criteria was all pleural effusions either exudative or transudative. Exclusion criteria wasinsufficient pleural fluid. The data was collected and analysed for frequencies with percentages and mean with standard deviationusing SPSS version 20.Results: In this study a total of 422 pleural fluid out of which 77(18.24%) PPE cases were analysed. The age range was from11-80 years with mean age of 54.34±9.22 years. Amongst these PPE 41 were from males patients and 36 from femalepatients. Simple PPE were 21(27.30%), complicated PPE 37(48.05%) and empyema were 29(37.7%).Conclusion: The laboratory parameters for differentiation of different types of parapneumonic effusion have significant role indifferentiation and management of different types of PPE and must be analysed in laboratory to separate the subtypes and guidethe physician about using non invasive and invasive management modalities.

scholarly journals Parapneumonic effusions: Features, diagnostics and treatment options

2014 ◽  
Vol 142 (11-12) ◽  
pp. 680-687
Author(s):  
Mirna Djuric ◽  
Dejan Djuric ◽  
Tamara Culibrk ◽  
Djordje Povazan
Keyword(s):  
Treatment Options ◽  
Clinical Problem ◽  
Chronic Obstructive ◽  
Parapneumonic Effusion ◽  
Obstructive Pulmonary Disease ◽  
Radiological Features ◽  
Thoracic Drainage ◽  
Inflammatory Processes ◽  
Ct Finding ◽  
Disease Present

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.

scholarly journals Serum Amyloid Alpha in Parapneumonic Effusions

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Vagelis Boultadakis ◽  
Vasilis Skouras ◽  
Demosthenes Makris ◽  
Aggeliki Damianaki ◽  
Dimitrios J. Nikoulis ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Diagnostic Performance ◽  
Serum Amyloid ◽  
Parapneumonic Effusion ◽  
Pleural Thickening ◽  
Glucose Levels ◽  
Tnf Α ◽  
Significant Difference ◽  
Α Level ◽  
Fluid Levels

Study objectives. To assess serum amyloid alpha (SAA) pleural fluid levels in parapneumonic effusion (PPE) and to investigate SAA diagnostic performance in PPE diagnosis and outcome.Methods. We studied prospectively 57 consecutive patients with PPE (empyema (EMP), complicated (CPE), and uncomplicated parapneumonic effusion (UPE)). SAA, CRP, TNF-α, IL-1β, and IL-6 levels were evaluated in serum and pleural fluid at baseline. Patients were followed for 6-months to detect pleural thickening/loculations.Results. Pleural SAA levels (mg/dL) median(IQR) were significantly higher in CPE compared to UPE (P<0.04); CRP levels were higher in EMP and CPE compared to UPE (P<0.01). There was no significant difference between IL-1β, IL-6, TNF-α level in different PPE forms. No significant association between SAA levels and 6-month outcome was found. At 6-months, patients with no evidence of loculations/thickening had significantly higher pleural fluid pH, glucose levels (P=0.03), lower LDH (P=0.005), IL-1β levels (P=0.001) compared to patients who presented pleural loculations/thickening.Conclusions. SAA is increased in complicated PPE, and it might be useful as a biomarker for UPE and CPE diagnosis. SAA levels did not demonstrate considerable diagnostic performance in identifying patients who develop pleural thickening/loculations after a PPE.

scholarly journals Clinical, Laboratory and Radiographic Features of Patients with Pneumonia and Parapneumonic Effusions

2016 ◽  
Vol 4 (3) ◽  
pp. 428-434 ◽  
Author(s):  
Sanja Petrusevska-Marinkovic ◽  
Irena Kondova-Topuzovska ◽  
Zvonko Milenkovic ◽  
Goran Kondov ◽  
Ankica Anastasovska
Keyword(s):  
Clinical Laboratory ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Pleuritic Chest Pain ◽  
Radiographic Features ◽  
Reactive Protein ◽  
Pulmonary Changes ◽  
Male Patients

BACKGROUND: Parapneumonic effusions complicating pneumonia are associated with increased morbidity and mortality.AIM: To determine the role of the clinical, laboratory and radiographic features to the differential diagnosis of patients with community- acquired pneumonia (CAP) without effusion, uncomplicated parapneumonic effusion (UCPPE) and complicated parapneumonic effusion (CPPE).MATERIAL AND METHODS: We analysed 148 patients with CAP without effusion, 50 with UCPPE and 44 with CPPE. In three groups of patients, the majority was male patients (58.11%, 58%, 61.36%) consequently.RESULTS: The chronic heart failure was the most common comorbidity in a group with CAP (28; 18.92%) and UCPPE (7; 14%), alcoholism (12;12.77%) in a group with CPPE. Patients with CPPE had significantly longer fever compared to patients with CAP without effusion (p = 0.003). Pleuritic chest pain (86.36%) and dyspnea (88.64%) were the most common symptoms in CPPE, then to group with UCPPE (60%; 52%), and in CAP without effusion (25.68%; 47,97%). Diffuse pulmonary changes were detected more frequently in the group with CAP without effusion compared with the group with CPPE (64.86 % vs. 27.27 %), while the segment lung changes were more common in patients with CPPE (50% vs. 20.27%). Patients with CPPE were significant with higher erythrocytes sedimentation rate (ESR), white blood cells (WBC) and serum C- reactive protein (CRP) than it the other two groups (p = 0.00090, p = 0.01, p= 0.000065).CONCLUSION:Proper analysis of clinical, laboratory and radiographic features of patients with CAP and parapneumonic effusion can prevent mismanagement in these patients and will reduce morbidity and mortality. 

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