link
Bookmarks
Parapneumonic Effusion and Empyema
Michael R. Aquino, MD, MHSc
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Subscribe
0
3
5
0

KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Pleural effusions are classified as transudative or exudative
            • Transudative: Due to hydrostatic & oncotic imbalances
            • Exudative: Due to ↑ capillary permeability
          • Parapneumonic effusions are exudative
            • Stages of progression: Exudative (simple) → fibrinopurulent (complicated) → organized
          • Empyema is fibrinopurulent parapneumonic effusion

        IMAGING

        • Radiographic Findings

          • Ultrasonographic Findings

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              Selected References

                              1. de Benedictis FM et al: Complicated pneumonia in children. Lancet. 396(10253):786-98, 2020
                              2. Konietzke P et al: The value of chest magnetic resonance imaging compared to chest radiographs with and without additional lung ultrasound in children with complicated pneumonia. PLoS One. 15(3):e0230252, 2020
                              3. Liszewski MC et al: Lung magnetic resonance imaging for pneumonia in children. Pediatr Radiol. 47(11):1420-30, 2017
                              4. Long AM et al: 'Less may be best'-pediatric parapneumonic effusion and empyema management: lessons from a UK center. J Pediatr Surg. 51(4):588-91, 2015
                              5. Islam S et al: The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg. 47(11):2101-10, 2012
                              6. Heffner JE et al: Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 137(2):467-79, 2010
                              7. Calder A et al: Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 39(6):527-37, 2009
                              8. Hernández-Bou S et al: Pediatric parapneumonic pleural effusion: epidemiology, clinical characteristics, and microbiological diagnosis. Pediatr Pulmonol. 44(12):1192-200, 2009
                              9. Kurian J et al: Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. AJR Am J Roentgenol. 193(6):1648-54, 2009
                              10. Light RW: Clinical practice. Pleural effusion. N Engl J Med. 346(25):1971-7, 2002
                              11. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                              12. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                              13. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                              14. Ramnath RR et al: Implications of early sonographic evaluation of parapneumonic effusions in children with pneumonia. Pediatrics. 101(1 Pt 1):68-71, 1998
                              15. Donnelly LF et al: CT appearance of parapneumonic effusions in children: findings are not specific for empyema. AJR Am J Roentgenol. 169(1):179-82, 1997
                              Related Anatomy
                              Loading...
                              Related Differential Diagnoses
                              Loading...
                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Definitions

                                      • Pleural effusions are classified as transudative or exudative
                                        • Transudative: Due to hydrostatic & oncotic imbalances
                                        • Exudative: Due to ↑ capillary permeability
                                      • Parapneumonic effusions are exudative
                                        • Stages of progression: Exudative (simple) → fibrinopurulent (complicated) → organized
                                      • Empyema is fibrinopurulent parapneumonic effusion

                                    IMAGING

                                    • Radiographic Findings

                                      • Ultrasonographic Findings

                                        • CT Findings

                                          • MR Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          Selected References

                                                          1. de Benedictis FM et al: Complicated pneumonia in children. Lancet. 396(10253):786-98, 2020
                                                          2. Konietzke P et al: The value of chest magnetic resonance imaging compared to chest radiographs with and without additional lung ultrasound in children with complicated pneumonia. PLoS One. 15(3):e0230252, 2020
                                                          3. Liszewski MC et al: Lung magnetic resonance imaging for pneumonia in children. Pediatr Radiol. 47(11):1420-30, 2017
                                                          4. Long AM et al: 'Less may be best'-pediatric parapneumonic effusion and empyema management: lessons from a UK center. J Pediatr Surg. 51(4):588-91, 2015
                                                          5. Islam S et al: The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg. 47(11):2101-10, 2012
                                                          6. Heffner JE et al: Diagnostic utility and clinical application of imaging for pleural space infections. Chest. 137(2):467-79, 2010
                                                          7. Calder A et al: Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 39(6):527-37, 2009
                                                          8. Hernández-Bou S et al: Pediatric parapneumonic pleural effusion: epidemiology, clinical characteristics, and microbiological diagnosis. Pediatr Pulmonol. 44(12):1192-200, 2009
                                                          9. Kurian J et al: Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. AJR Am J Roentgenol. 193(6):1648-54, 2009
                                                          10. Light RW: Clinical practice. Pleural effusion. N Engl J Med. 346(25):1971-7, 2002
                                                          11. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                                          12. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                                          13. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                                          14. Ramnath RR et al: Implications of early sonographic evaluation of parapneumonic effusions in children with pneumonia. Pediatrics. 101(1 Pt 1):68-71, 1998
                                                          15. Donnelly LF et al: CT appearance of parapneumonic effusions in children: findings are not specific for empyema. AJR Am J Roentgenol. 169(1):179-82, 1997