Based on the patients history of infectious respiratory symptoms and results of pleural fluid studies revealing a low pleural fluid glucose concentration and borderline low pH, the case patient has class 2 or typical parapneumonic effusion. Typical parapneumonic effusions can usually be treated with antibiotics and do not require further intervention after the initial diagnostic thoracentesis. Both complicated parapneumonic effusions and empyema would have a pleural fluid pH less than 7.2. An empyema would also have a positive Gram stain or culture. A pleural effusion due to CHF would be a transudate, with pleural fluid pH and glucose similar to serum values (this was an exudate).2
- Typical parapneumonic effusion.
3. Light RW. Pleural diseases. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001:44-45, 57-8, 163-5.
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