Management and treatment of pleural effusion and empyema

Approximately 1.5 million patients are diagnosed with pleural effusion each year in the United States. Clinical manifestations of pleural effusion include dyspnea, pleuritic chest pain, cough, fever, fever, chills and weight loss and depending on the underlying disease. Diagnostic tools include chest radiograph, ultrasound, and computed tomography {CT).Ultrasound guided pigtail catheters as the initial draining method is strongly suggested. Light and Rodriguez treatment for pleural effusion and empyema is useful. The American College of Chest Physicians panel grouped management of pleural effusion into six categories: no drainage, therapeutic thoracentesis, tube thoracostomy be, fibrinolytic therapy, videoassisted thorcoscopy (VATS) and open surgery. Uncomplicated effusions (category1or 2) generally resolve with antibiotics alone. Drainage is recommended for management of patients in category 3 or 4.Therapeutic thoracentesis and tube thoracotomy is insufficient for managing patients in category 3 or 4.Fibrinolytic drugs, VATS, and surgery are better choices in these patients. High mortality inpleural effusions is due to mismanagement. Antibiotics of choice in pleural effusions are penicillin’s, cephalosporins, clindamycin, metronidazole, vancomycin, and quinolones. Aminoglycosides have poor penetration in the pleural space, and should not be used alone to treat gramnegative empyema’s.