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