{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:27:43Z","timestamp":1787700463512,"version":"build-2784847793"},"reference-count":79,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Infective pleural effusions are mainly represented by parapneumonic effusions and empyema. These conditions are a spectrum of pleural diseases that are commonly encountered and carry significant mortality and morbidity rates reaching upwards of 50%. The causative etiology is usually an underlying bacterial pneumonia with the subsequent seeding of the infectious culprit and inflammatory agents to the pleural space leading to an inflammatory response and fibrin deposition. Radiographical evaluation through a CT scan or ultrasound yields high specificity and sensitivity, with features such as septations or pleural thickening indicating worse outcomes. Although microbiological yields from pleural studies are around 56% only, fluid analysis assists in both diagnosis and prognosis by evaluating pH, glucose, and other biomarkers such as lactate dehydrogenase. Management centers around antibiotic therapy for 2\u20136 weeks and the drainage of the infected pleural space when the effusion is complicated through tube thoracostomies or surgical intervention. Intrapleural enzymatic therapy, used to increase drainage, significantly decreases treatment failure rates, length of hospital stay, and surgical referrals but carries a risk of pleural hemorrhage. This comprehensive review article aims to define and delineate the progression of parapneumonic effusions and empyema as well as discuss pathophysiology, diagnostic, and treatment modalities with aims of broadening the generalist\u2019s understanding of such complex disease by reviewing the most recent and relevant high-quality evidence.<\/jats:p>","DOI":"10.3390\/clinpract14030068","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T09:30:03Z","timestamp":1715851803000},"page":"870-881","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Infective Pleural Effusions\u2014A Comprehensive Narrative Review Article"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6983-5749","authenticated-orcid":false,"given":"Mohammad","family":"Abdulelah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Massachusetts Chan Medical School\u2014Baystate Campus, Springfield, MA 01199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Abu Hishmeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Massachusetts Chan Medical School\u2014Baystate Campus, Springfield, MA 01199, USA"},{"name":"Department of Pulmonary and Critical Care Medicine, University of Massachusetts Chan Medical School\u2014Baystate Campus, Springfield, MA 01199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2120306","DOI":"10.1001\/jamanetworkopen.2021.20306","article-title":"Prevalence, Causes, and Health Care Burden of Pleural Effusions Among Hospitalized Adults in China","volume":"4","author":"Tian","year":"2021","journal-title":"JAMA Netw. 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