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 language | English (US) |
|---|---|
| Pages (from-to) | 563-577 |
| Number of pages | 15 |
| Journal | The Lancet Respiratory Medicine |
| Volume | 3 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2015 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Pleural infection
T2 - Past, present, and future directions
AU - Corcoran, John P.
AU - Wrightson, John M.
AU - Belcher, Elizabeth
AU - DeCamp, Malcolm M.
AU - Feller-Kopman, David
AU - Rahman, Najib M.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - 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.
AB - 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.
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U2 - 10.1016/S2213-2600(15)00185-X
DO - 10.1016/S2213-2600(15)00185-X
M3 - Article
C2 - 26170076
AN - SCOPUS:84943147080
VL - 3
SP - 563
EP - 577
JO - The Lancet Respiratory Medicine
JF - The Lancet Respiratory Medicine
SN - 2213-2600
IS - 7
ER -