skip to main content

Pleural infection — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

EasyPleural DiseasePleural infectionSCE Respiratory

A 54-year-old man is admitted with fever, pleuritic pain and a moderate loculated pleural effusion after 5 days of pneumonia. Pleural aspirate is turbid with pH 7.08, glucose 1.4 mmol/L, LDH 1,850 IU/L and Gram-positive cocci on microscopy. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Antibiotics plus image-guided small-bore chest drain insertion

Frankly infected fluid with pH below 7.2 requires prompt drainage plus antibiotics. Antibiotics alone or one-off aspiration risks persistent sepsis and pleural organisation. Pleurodesis and diuretics address different mechanisms and would be inappropriate in pleural infection.

Reference: BTS Pleural Disease Guideline 2023