MANAGEMENT OF PARAPNEUMONIC EFFUSIONS - 09/09/11

Doi : 10.1016/S0272-5231(05)70084-8

Richard W. Light, MD ^a,^b, R. Michael Rodriguez, MD ^a,^b

^a Vanderbilt University (RWL, RMR)

^b Pulmonary Diseases, Saint Thomas Hospital, Nashville, Tennessee (RWL, RMR)

Résumé

The annual incidence of bacterial pneumonia in the United States is estimated at 4 million and approximately 20% of those cases require hospitalization.^{32 Neiderman M.S., Bass J.B., Campbell G.D. , et al. Guidelines for the initial management of adults with community-acquired pneumonia: Diagnosis, assessment of severity, and initial antimicrobial therapy Am Rev Respir Dis 1993 ; 148 : 1418-1426

Cliquez ici pour aller à la section Références} The incidence of parapneumonic effusion in patients hospitalized with pneumonia is about 40%.^{25 Light R.W., Girard W.M., Jenkinson S.G. , et al. Parapneumonic effusions Am J Med 1980 ; 69 : 507-511 [cross-ref]

Cliquez ici pour aller à la section Références} The morbidity and mortality rates in patients with pneumonia and pleural effusions are greater than in patients with pneumonia alone. In one recent study,^{16 Hasley P.B., Albaum M.N., Li Y.-H. , et al. Do pulmonary radiographic findings at presentation predict mortality in patients with community-acquired pneumonia? Arch Intern Med 1996 ; 156 : 2206-2212

Cliquez ici pour aller à la section Références} the relative risk of mortality in patients with community-acquired pneumonia was 7.0 times higher for patients with bilateral pleural effusions and 3.4 times higher for patients with unilateral-pleural effusion of moderate or greater size compared with other patients with community-acquired pneumonia. Delay in instituting proper therapy for effusions is responsible for much of the increased morbidity and mortality.