Respiratory · Year 1 · from Respiratory
Case 1: Parapneumonic Effusion and Empyema
Clinical Image
Source: Wikimedia Commons - Pleural effusion - CC BY-SA 3.0
Patient Presentation
A 58-year-old man presents with 5 days of worsening right-sided chest pain, productive cough with purulent sputum, and fever. He was treated with oral antibiotics by his primary care physician 3 days ago for pneumonia but has not improved. The chest pain is sharp, worse with breathing, and he has noticed increasing shortness of breath. He has a history of alcohol use disorder.
Demographics
- Age: 58 years
- Sex: Male
- Past Medical History: Alcohol use disorder, poor dentition
- Medications: Amoxicillin-clavulanate (started 3 days ago)
- Social History: Heavy alcohol use (6-8 drinks daily), homeless periods in the past
Chief Complaint
Worsening chest pain, fever, and dyspnea despite antibiotic treatment
Physical Examination
- Temperature: 39.2°C
- Blood pressure: 98/62 mmHg
- Heart rate: 112 bpm
- Respiratory rate: 28/min
- Oxygen saturation: 90% on room air
- General: Ill-appearing, diaphoretic
- Respiratory:
- Dullness to percussion right base to mid-chest
- Decreased breath sounds right lower lung
- Decreased tactile fremitus
- Egophony at fluid-air interface
- Cardiac: Tachycardic, regular
Workup
- WBC: 22,400/μL with left shift
- Procalcitonin: 8.5 ng/mL (markedly elevated)
- Chest X-ray: Large right pleural effusion with loculations, right lower lobe consolidation
- CT chest: Loculated right pleural effusion with pleural thickening and enhancement (split pleura sign), underlying consolidation
- Thoracentesis (ultrasound-guided):
- Appearance: Turbid, purulent
- pH: 6.9 (very low)
- Glucose: 20 mg/dL (very low)
- LDH: 2,850 IU/L (very high)
- Protein: 5.2 g/dL
- WBC: 45,000/μL (95% neutrophils)
- Gram stain: Gram-positive cocci in chains
- Culture: Streptococcus anginosus
Diagnosis
Complicated Parapneumonic Effusion/Empyema
Treatment
- IV antibiotics: Broad-spectrum initially (ceftriaxone + metronidazole), narrow based on culture
- Chest tube drainage (large-bore preferred for thick pus):
- Indicated for: pH <7.20, glucose <60, positive Gram stain/culture, or frank pus
- Intrapleural fibrinolytic therapy: tPA + DNase if loculated/incomplete drainage
- Surgical consultation: VATS debridement and decortication if medical therapy fails
- Nutritional support
- Dental evaluation for potential source
- Alcohol cessation counseling and resources
Physiological Principles Demonstrated
- Parapneumonic effusion stages:
- Exudative (simple): Sterile, responds to antibiotics alone
- Fibrinopurulent (complicated): Bacterial invasion, loculations form, drainage needed
- Organizing (empyema): Frank pus with thick pleural peel
- Light's criteria application: This is clearly an exudate (protein >0.5 ratio, LDH >0.6 ratio, pleural LDH >2/3 upper limit of normal serum LDH).
- Pleural fluid pH significance: pH <7.20 indicates significant bacterial metabolism and anaerobic glycolysis in the pleural space, predicting failure of antibiotics alone.
- Aspiration risk factors: Alcohol use, poor dentition, and aspiration increase risk of anaerobic and streptococcal infections.