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Pneumonia with parapneumonic effusion — ACEM Fellowship MCQ

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HardRespiratory emergenciesPneumonia with parapneumonic effusionACEM Fellowship

A 58-year-old woman presents to a Newcastle ED, triage category 2, with fever, pleuritic pain and hypoxia. CXR shows right lower-lobe consolidation and a moderate effusion. CRP is 310 mg/L, WCC 24 and bedside ultrasound shows septations in the pleural fluid. What is the most appropriate investigation?

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Correct answer: B — Diagnostic pleural aspiration under ultrasound

A septated effusion with sepsis suggests complicated parapneumonic effusion; ultrasound-guided diagnostic aspiration guides drainage and antibiotics.

Reference: ACEM respiratory curriculum; pleural infection guidance