Why do two procedures when one will do? Thoracic ultrasound guiding management of complex pleural space infections

Abstract

Complicated parapneumonic effusions and empyemas are associated with significant morbidity and mortality. When managing a potentially infected pleural space, current guidelines support performing diagnostic thoracentesis prior to consideration of chest tube insertion. We present a case demonstrating our clinical approach to the management of complicated parapneumonic effusions and empyemas, with patient presentation and initial point-of-care thoracic ultrasound assessment guiding consideration of immediate insertion of small-bore (14 F) chest tube.

Keywords

• Thoracic ultrasound (TUS)
• Point of care ultrasound (POCUS)
• Complicated parapneumonic effusions
• Empyema
• Septations