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  • Title: [Parapneumonic pleural effusion, pleural empyema: medical and surgical aspects].
    Author: Gugger M, Lardinois D.
    Journal: Schweiz Med Wochenschr; 1999 Apr 10; 129(14):556-62. PubMed ID: 10321008.
    Abstract:
    The following are essential for prophylaxis and treatment of empyema: antibiotic therapy for pneumonia, based on susceptibility results; early detection of parapneumonic effusions (decubitus radiograph, sonography); immediate diagnostic thoracocentesis if a parapneumonic effusion is large, increasing despite antibiotic therapy, if it is associated with clinical deterioration or if empyema is suspected; assessment of the stage of parapneumonic effusion or empyema (clinical signs, sonography, CT, laboratory parameters); immediate therapeutic thoracocentesis of frank empyema, in loculated empyema fibrinolytic agents may be used; early surgical intervention if conservative management fails; complete thoracoscopic decortication, if necessary open thoracotomy to assure complete reexpansion of the lung.
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