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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Last updated: August 9, 2019
Citation
Auwaerter, Paul G, and John G Bartlett. "Empyema and Parapneumonic Effusions." Johns Hopkins ABX Guide, The Johns Hopkins University, 2019. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540188/3.2/Empyema.
Auwaerter PG, Bartlett JG. Empyema and Parapneumonic Effusions. Johns Hopkins ABX Guide. The Johns Hopkins University; 2019. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540188/3.2/Empyema. Accessed August 17, 2019.
Auwaerter, P. G., & Bartlett, J. G. (2019). Empyema and Parapneumonic Effusions. In Johns Hopkins ABX Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540188/3.2/Empyema
Auwaerter PG, Bartlett JG. Empyema and Parapneumonic Effusions [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2019. [cited 2019 August 17]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540188/3.2/Empyema.
* Article titles in AMA citation format should be in sentence-case
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T1 - Empyema and Parapneumonic Effusions
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A1 - Auwaerter,Paul,M.D.
AU - Bartlett,John,M.D.
Y1 - 2019/08/09/
BT - Johns Hopkins ABX Guide
UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540188/3.2/Empyema
PB - The Johns Hopkins University
DB - Johns Hopkins Guide
DP - Unbound Medicine
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