Complicated pneumonia is defined as pulmonary parenchymal infection that is complicated by parapneumonic effusions, multi-lobar disease, abscesses or cavities, necrotising pneumonia, empyema, or pneumothorax of bronchopleural fistula; or pneumonia that is a complication of bacteraemic disease that includes other sites of infection. Aspiration pneumonia is diagnosed based on clinical signs or symptoms of pneumonia in a person with a history or risk factors for aspiration.Sputum or tracheal Gram stain reveals mixed flora.Infection usually involves the dependent lung lobe.Complications of disease include lung abscess and empyema. Infectious Disease Advisor: IDSA, PIDS Update Pediatric CAP Guidelines for Parapneumonic Effusion Management Empyema is defined as the presence of pus in the pleural space.

Understanding the Context

Risk factors include pneumonia, iatrogenic intervention in the pleural space, diabetes, and alcohol abuse. In patients with symptoms and signs of infection and a significant pleural effusion, thoracentesis (pleural aspiration) must b... An important nail sign of systemic disease linked with underlying pulmonary, cardiovascular, neoplastic, infectious, hepatobiliary, mediastinal, endocrine, and gastrointestinal disorders. Digital clubbing may also occur in isolation (e.g., familial clubbing, as an autosomal-dominant trait).

Key Insights

Definition Clubbing is a bulbous uniform swelling of the soft tissue of the terminal phalanx of a digit ... E Empyema Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) Evaluation of chronic cough Evaluation of clubbing Evaluation of cyanosis in the newborn Evaluation of dyspnea Evaluation of hemoptysis Evaluation of mediastinal mass Evaluation of persistent pulmonary infiltrate Evaluation of pleuritis Evaluation of respiratory ... Empyema is considered to be a sub-classification of parapneumonic pleural effusion. A parapneumonic effusion describes the build-up of activated pleural fluid which is associated with a lung infection ... Pleural effusions complicate up to 57% of bacterial pneumonias.

Final Thoughts

They vary in severity, ranging from uncomplicated effusions to empyema. Some require only antibiotics and observation, while others ...