Complications
Present in up to one third of patients.[83] Effusions associated with pneumonias are typically exudative and occur as a result of lobar consolidation with leukocytes and inflammation. A diagnostic, and possibly therapeutic, thoracentesis is indicated.
In severe pneumonia, purulent collections may occur in the lung itself (abscess) as opposed to collecting in the pleural space (empyema). When this occurs, a cardiothoracic surgeon should be consulted to evaluate for surgical drainage, debridement, or partial pneumonectomy.
Respiratory failure occurs as a result of decreased functional lung tissue, but more significantly because of the septic response that occurs with cytokines and chemokines, causing intense inflammation and coagulation of the entire area of the lung. Supplemental oxygen/intubation is considered.
Rarely, in immunocompromised patients, infection may spread from the lung to other sites in the body.[3]
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