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Pleural infection — SCE Respiratory MCQ

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EasyPleural DiseasePleural infectionSCE Respiratory

A 56-year-old man with pneumonia remains febrile despite antibiotics. Ultrasound shows a complex septated pleural collection. Pleural fluid pH is 7.08, glucose is 1.6 mmol/L and Gram stain shows Gram-positive cocci. What is the most appropriate management?

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Correct answer: D — Insert a small-bore chest drain with antibiotics

Low pleural pH, low glucose, septations and organisms indicate pleural infection needing prompt drainage plus antibiotics. Delayed repeat aspiration risks progression to organised empyema. Pleurodesis is for recurrent pneumothorax or malignant effusion, not active pleural infection.

Reference: BTS Pleural Disease Guideline 2023