Johns Hopkins ABX Guide
Empyema and Parapneumonic Effusions
Empyema and Parapneumonic Effusions is a topic covered in the Johns Hopkins ABX Guide.
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PATHOGENS
- S. pneumoniae and other streptococci (50%)
- Streptococcus intermedius complex ([previously S. milleri], S. anginosus, S. constellatus) now dominates in community-acquired cases.
- S. aureus including MRSA (10%)
- Anaerobes (20%)
- Gram-negative bacilli (GNB, 10%)
- Noscomial: Gram-negative bacilli and S. aureus (MRSA)
- Rare causes:
- Mycobacterium tuberculosis
- Enterococcus
- Actinomyces
- Other: viruses are a highly unusual cause except for influenza complicated by bacterial superinfection
- Fungi: rare except immunocompromised hosts
- Parasites:
- Echinococcus
- Entamoeba histolytica
- Paragonimus westermani
- Major causes in CAP: S. pneumoniae, streptococcal species, S. aureus and anaerobic bacteria (polymicrobial).
- Fulminant course in healthy host: usually MRSA, especially if following influenza as a bacterial superinfection.
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PATHOGENS
- S. pneumoniae and other streptococci (50%)
- Streptococcus intermedius complex ([previously S. milleri], S. anginosus, S. constellatus) now dominates in community-acquired cases.
- S. aureus including MRSA (10%)
- Anaerobes (20%)
- Gram-negative bacilli (GNB, 10%)
- Noscomial: Gram-negative bacilli and S. aureus (MRSA)
- Rare causes:
- Mycobacterium tuberculosis
- Enterococcus
- Actinomyces
- Other: viruses are a highly unusual cause except for influenza complicated by bacterial superinfection
- Fungi: rare except immunocompromised hosts
- Parasites:
- Echinococcus
- Entamoeba histolytica
- Paragonimus westermani
- Major causes in CAP: S. pneumoniae, streptococcal species, S. aureus and anaerobic bacteria (polymicrobial).
- Fulminant course in healthy host: usually MRSA, especially if following influenza as a bacterial superinfection.
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Last updated: April 4, 2020
Citation
Auwaerter, Paul G. "Empyema and Parapneumonic Effusions." Johns Hopkins ABX Guide, The Johns Hopkins University, 2020. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540188/all/Empyema_and_Parapneumonic_Effusions.
Auwaerter PG. Empyema and Parapneumonic Effusions. Johns Hopkins ABX Guide. The Johns Hopkins University; 2020. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540188/all/Empyema_and_Parapneumonic_Effusions. Accessed July 30, 2021.
Auwaerter, P. G. (2020). Empyema and Parapneumonic Effusions. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540188/all/Empyema_and_Parapneumonic_Effusions
Auwaerter PG. Empyema and Parapneumonic Effusions [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2020. [cited 2021 July 30]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540188/all/Empyema_and_Parapneumonic_Effusions.
* Article titles in AMA citation format should be in sentence-case
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PB - The Johns Hopkins University
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