Community Acquired Pneumonia & Empyema
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Community Acquired Pneumonia & Empyema

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This case will help you managing the Community Acquired Pneumonia complicated with empyema

This case will help you managing the Community Acquired Pneumonia complicated with empyema

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  • 1. Community Acquired Nosocomial Pathogen Bacterial 70-80% 90% Streptococcus pneumoniae 60-75% 3-9% Hemophilus influenza 4-5% Legionella sp. 2-5% Up to 25% Staphylococcus aureus 1-5% 10-20% Gram-negative bacilli Rare 50% Atypical 10-20% Rare Mycoplasma pneumoniae 5-18% - Chlamydia psittaci 2-3% - Coxiella burnetii 1% - Virus 10-20% Rare Influenza - 8% Hantavirus - Rare
  • 2. Pleural Effusion Fluids PH 6.5 Glucose 73 Protein 3.2 Albumin 1.2 LDH 1092 C+S No growth
  • 3. TEST Result Normal HIV Negative Negative IgG 991 700 – 1600 IgG subtypes I – II – III Pending - IgM 75 40 – 230 IgA 472 70 – 400 C3 122 90 – 207 C4 21 17.4 – 52.2
  • 4. Pleural fluid sample Color Cloudy - Orange WBC 350 Neut 93% Lymph 2% Mono 5% Glucose Not done PH Not done C+S No growth
  • 5. Pleural Risk Pleural fluid Pleural fluid space Drainage Category of bacteriology chemistry anatomy outcome PH •Minima & Very C+S A0 & Bx Cx U/K 1 No l FF low unknown •<10mm •Small – moderate & PH Negative A1 & B0 C0 2 Low No FF >7.2 C+S •>10mm •Large Positive FF B1 3 Mod Yes C+S •Thick pleura OR PH A2 OR C1 •Hemi- <7.2 thorax B2 Pus 4 High Yes