To further analyze the need for immediate drainage in complicated parapneumonic effusions, we com­bined our data with cases previously reported. In 1976, Potts et al reported seven cases of complicated parapneumonic effusions. The clinical course of two of the seven cases was presented. One patients pleural fluid became loculated and eventually required decor­tication for improvement. [...]

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The major finding of our retrospective study was that antibiotic therapy without chest tube drainage was sufficient for most of our patients with complicated parapneumonic effusions. The initial response to ther­apy and the long-term outcome were not different in patients treated with antibiotics alone or antibiotics plus immediate chest tube drainage. Although delayed empyema formation [...]

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Clinical Course of Complicated Parapneumonic Effu­sions Treated with Antibiotics Alone All 16 cases of complicated parapneumonic effusions treated with antibiotics alone were closely reviewed. There was one death in an 88-year-old patient with a pneumococcal pneumonia. He refused aggressive therapy. The follow-up period for all 15 remaining patients was greater than three months (mean, 16.5 [...]

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Clinical Course of Empyema and Complicated and Uncomplicated Parapneumonic Effusions Of the 161 charts reviewed, there were 62 cases included in the study (Fig 1). There was no significant difference in the duration of hospitalization or duration of elevated temperature in patients with complicated or uncomplicated parapneumonic eflusions; however, the group with empyema had a [...]

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Clinical Course of Empyema and Complicated and Uncomplicated Effusions We determined if the clinical course of complicated parapneu­monic effusions more closely followed the course of empyema, which required chest tube drainage, or of uncomplicated parapneu­monic effusions, which do not require drainage. The clinical course was determined by the duration of hospitalization due to the primary [...]

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Parapneumonic effusions are a common complica­tion of bacterial pneumonia. The treatment re­quired for parapneumonic effusions has been largely determined by the characteristics of the pleural fluid. Grossly purulent pleural fluid (ie, empyema) requires drainage and does not resolve with antibiotic therapy alone. Pleural fluid which neither is purulent, Gram- stain positive, or culture-positive, nor has [...]

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The value of a study based on reports from the patients will be dependent on the cooperation of the patients. We found good cooperation in filling out the diaries; only seven patients discontinued the study for this reason. They should use the treatments every morning and evening, but most patients used the treatments more often. [...]

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