Approximately 1 million patients develop parapneumonic effusions (PPEs) annually in the United States. The outcome of these effusions is related to the interval between the onset of clinical symptoms and presentation to the physician, comorbidities, and timely management. Early antibiotic treatment usually prevents the development of a PPE and its progression to a complicated PPE and empyema. P...

Adenosine deaminase activity (ADA) was assayed in pleural fluid and serum of 42 subjects with pleural effusion. Twenty-nine of them had TB pleural effusion and the remaining 13 had pleural effusion due to non-TB respiratory diseases. Serum adenosine deaminase activity were also measured in 32 pulmonary tuberculosis patients without pleural effusion and equal numbers of healthy controls without ...

BACKGROUND It is generally recommended that pleural fluid samples from pleural effusions of unknown cause be cultured for bacteria, mycobacteria, and fungi. However, the utility of this practice has been not been adequately assessed. DESIGN Retrospective review. SETTING Tertiary care, referral medical center. PATIENTS Five hundred twenty-five patients undergoing diagnostic thoracentesis a...

of large amount of pleural fluid with many polymorphonuclear leukocytes, bacteria and cellular debris. The pleural fluid becomes clottable due to leakage of plasma proteins and loss of fibrinolytic activity in pleural space resulting in the formation of thick layer of fibrin over parietal and visceral pleura. The migration of fibroblasts into pleural space leads to collagen deposition and along...

The diagnostic accuracy of myeloperoxidase (MPO) in pleural fluid, for differentiating between complicated and noncomplicated parapneumonic pleural effusions (PPE) evaluated prospectively. Seventy patients aged >18 yrs with PPE (36 complicated and 34 noncomplicated) were studied after admission to a tertiary referral teaching hospital. MPO concentration was measured in plasma and pleural fluid ...

We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and discriminate between complicated (CPPEs) and uncomplicated parapneumonic effusions (UPPEs). Stored p...

Background: The alteration of Th1 and Th2 cytokine levels is the subject of controversy in pleural effusions caused by malignancy, a situation that favors a Th2 immune response. Objective: To examine the different levels of IL-4 and IL-10 (Th2 cytokines), and IL-2 and interferon-γ (IFN-γ) (Th1 cytokines) in malignant and non-malignant pleural effusions. Method: The cytokine levels in pleural fl...

BACKGROUND A bacterial cause is not frequently identified in children with pneumonia complicated by parapneumonic effusion (ie, complicated pneumonia). OBJECTIVES To determine the frequency of positive blood and pleural fluid cultures in children with complicated pneumonia and to determine whether broad-range 16S rRNA polymerase chain reaction (PCR) improves identification of a microbiologic ...

METHODS Patients Pleural fluids from 374 patients meeting standard criteria for pleural infection were analysed. Patients were recruited in 52 UK centres between 1999 and 2008 (including mycoplasma peak periods), as part of previous randomized trials of intrapleural therapy in pleural infection. Inclusion criteria were clinical evidence of infection and pleural fluid that was macroscopically pu...