Empyema and Parapneumonic Effusions

Paul G. Auwaerter, M.D.

Empyema and Parapneumonic Effusions is a topic covered in the Johns Hopkins ABX Guide.

To view the entire topic, please log in or purchase a subscription.

Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:

A COVID-19 Conversation - Variants, Vaccines, and Long-Term Effects

Coronavirus COVID-19 (SARS-CoV-2)

Suicide Risk in the COVID-19 Pandemic

Moderna COVID-19 Vaccine

BNT162b2 COVID-19 Vaccine (BioNTech/Pfizer)

Managing Stress and Coping with COVID-19

Johnson & Johnson COVID-19 Vaccine

-- The first section of this topic is shown below --

PATHOGENS

S. pneumoniae and other streptococci (50%)
- Streptococcus intermedius complex ([previously S. milleri], S. anginosus, S. constellatus) now dominates in community-acquired cases.
S. aureus including MRSA (10%)
Anaerobes (20%)
Gram-negative bacilli (GNB, 10%)
Noscomial: Gram-negative bacilli and S. aureus (MRSA)
Rare causes:
- Mycobacterium tuberculosis
- Enterococcus
- Actinomyces
- Other: viruses are a highly unusual cause except for influenza complicated by bacterial superinfection
  - Fungi: rare except immunocompromised hosts
    - Aspergillus
    - Cryptococcus
  - Parasites:
    - Echinococcus
    - Entamoeba histolytica
    - Paragonimus westermani

Major causes in CAP: S. pneumoniae, streptococcal species, S. aureus and anaerobic bacteria (polymicrobial).
- Fulminant course in healthy host: usually MRSA, especially if following influenza as a bacterial superinfection.

-- To view the remaining sections of this topic, please log in or purchase a subscription --

PATHOGENS

S. pneumoniae and other streptococci (50%)
- Streptococcus intermedius complex ([previously S. milleri], S. anginosus, S. constellatus) now dominates in community-acquired cases.
S. aureus including MRSA (10%)
Anaerobes (20%)
Gram-negative bacilli (GNB, 10%)
Noscomial: Gram-negative bacilli and S. aureus (MRSA)
Rare causes:
- Mycobacterium tuberculosis
- Enterococcus
- Actinomyces
- Other: viruses are a highly unusual cause except for influenza complicated by bacterial superinfection
  - Fungi: rare except immunocompromised hosts
    - Aspergillus
    - Cryptococcus
  - Parasites:
    - Echinococcus
    - Entamoeba histolytica
    - Paragonimus westermani

Major causes in CAP: S. pneumoniae, streptococcal species, S. aureus and anaerobic bacteria (polymicrobial).
- Fulminant course in healthy host: usually MRSA, especially if following influenza as a bacterial superinfection.

There's more to see -- the rest of this entry is available only to subscribers.