Infectious Diseases of the Pleura

Pleural infection is a common condition and one of the leading causes of morbidity and mortality worldwide. Infection of the pleura and pleural space is most often the result of an infectious process in the ipsilateral lung but can also be seen secondary to trauma or intraabdominal infection (Hughes and Van Scoy, Semin Respir Infect 6:94-102, 1991; Magovern and Rusch, Chest Surg Clin N Am 4:561-82, 1994). Many of the pleural infections discussed in this chapter have similar clinical and radiological presentations and thoracentesis with Gram, acid-fast, and fungal stains on the pleural fluid should be performed during the initial workup (George et al., Clin Chest Med 6:63-75, 1985). Pleural biopsy for histology and culture is only indicated if the results of the initial investigation are non-diagnostic or malignancy is suspected. The range of causative organisms is wide and includes bacterial, mycobacterial, fungal, and parasitic agents.