Pleural infection: Past, present, and future directions

John P. Corcoran, John M. Wrightson, Elizabeth Belcher, Malcolm M. DeCamp, David Feller-Kopman, Najib M. Rahman

Research output: Contribution to journalArticle

Abstract

Pleural space infections are increasing in incidence and continue to have high associated morbidity, mortality, and need for invasive treatments such as thoracic surgery. The mechanisms of progression from a non-infected, pneumonia-related effusion to a confirmed pleural infection have been well described in the scientific literature, but the route by which pathogenic organisms access the pleural space is poorly understood. Data suggests that not all pleural infections can be related to lung parenchymal infection. Studies examining the microbiological Prof.ile of pleural infection inform antibiotic choice and can help to delineate the source and pathogenesis of infection. The development of radiological methods and use of clinical indices to predict which patients with pleural infection will have a poor outcome, as well as inform patient selection for more invasive treatments, is particularly important. Randomised clinical trial and case series data have shown that the combination of an intrapleural tissue plasminogen activator and deoxyribonuclease therapy can potentially improve outcomes, but the use of this treatment as compared with surgical options has not been precisely defined, particularly in terms of when and in which patients it should be used.

Original languageEnglish (US)
Pages (from-to)563-577
Number of pages15
JournalThe Lancet Respiratory Medicine
Volume3
Issue number7
DOIs
StatePublished - Jul 1 2015

Fingerprint

Infection
Literature
Deoxyribonucleases
Tissue Plasminogen Activator
Direction compound
Patient Selection
Thoracic Surgery
Pneumonia
Therapeutics
Randomized Controlled Trials
Anti-Bacterial Agents
Morbidity
Lung
Mortality
Incidence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Corcoran, J. P., Wrightson, J. M., Belcher, E., DeCamp, M. M., Feller-Kopman, D., & Rahman, N. M. (2015). Pleural infection: Past, present, and future directions. The Lancet Respiratory Medicine, 3(7), 563-577. https://doi.org/10.1016/S2213-2600(15)00185-X

Pleural infection : Past, present, and future directions. / Corcoran, John P.; Wrightson, John M.; Belcher, Elizabeth; DeCamp, Malcolm M.; Feller-Kopman, David; Rahman, Najib M.

In: The Lancet Respiratory Medicine, Vol. 3, No. 7, 01.07.2015, p. 563-577.

Research output: Contribution to journalArticle

Corcoran, JP, Wrightson, JM, Belcher, E, DeCamp, MM, Feller-Kopman, D & Rahman, NM 2015, 'Pleural infection: Past, present, and future directions', The Lancet Respiratory Medicine, vol. 3, no. 7, pp. 563-577. https://doi.org/10.1016/S2213-2600(15)00185-X
Corcoran, John P. ; Wrightson, John M. ; Belcher, Elizabeth ; DeCamp, Malcolm M. ; Feller-Kopman, David ; Rahman, Najib M. / Pleural infection : Past, present, and future directions. In: The Lancet Respiratory Medicine. 2015 ; Vol. 3, No. 7. pp. 563-577.
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