Empyema - Symptoms, diagnosis and treatment | BMJ Best Practice Empyema is defined as the presence of pus in the pleural space 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
Empiema - Síntomas, diagnóstico y tratamiento | BMJ Best Practice El empiema se define como la presencia de pus en el espacio pleural Los factores de riesgo incluyen neumonía, intervención iatrogénica en el espacio pleural, diabetes y abuso de alcohol A los pacientes que presenten síntomas y signos de infección y un derrame pleural significativo, se les debe
Empiema - Sintomas, diagnóstico e tratamento | BMJ Best Practice O empiema é definido como a presença de pus no espaço pleural Fatores de risco incluem pneumonia, intervenção iatrogênica no espaço pleural, diabetes e abuso de álcool Em pacientes com sintomas e sinais de infecção e um derrame pleural significativo, deve-se realizar uma toracocentese (aspiraçã
Community-acquired pneumonia in children - BMJ Best Practice Community-acquired pneumonia (CAP) in childhood typically presents with fever and cough, together with hypoxemia (oxygen saturation ≤96% on pulse oximetry), tachypnea, and often signs of increased work of breathing (e g , chest retractions, nasal flaring, head bobbing, grunting) Most cases are c
Community-acquired pneumonia in children - BMJ Best Practice 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
Assessment of clubbing - BMJ Best Practice 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) Definition Clubbing is a bulbous uniform swelling of the soft tissue of the terminal phalanx of a digit
Symptoms, diagnosis and treatment - BMJ Best Practice Pleural effusion predominantly presents with breathlessness, but cough and pleuritic chest pain can be a feature The aetiology of the pleural effusion determines other signs and symptoms Postero-anterior chest x-ray will show an effusion of >200 mL of fluid An ultrasound, chest computed tomogr
Symptoms, diagnosis and treatment - BMJ Best Practice Definitive diagnosis is made with a positive laboratory test First-line treatment is with a fluoroquinolone or a newer-generation macrolide Complications are the same as those for pneumonia and include respiratory failure, parapneumonic effusion, empyema, lung abscess, and death
Acute cholecystitis - BMJ Best Practice Acute cholecystitis is a major complication of cholelithiasis (i e , gallstones); symptomatic gallstones are common before developing cholecystitis Patients typically present with pain and localised tenderness, with or without guarding, in the upper right quadrant There may be evidence of a systemic