Pleural infection

Pleural infection in adults remains a challenging condition to treat with poor outcomes that have persisted over several decades. Research efforts in recent years have significantly advanced our understanding of the aetiopathogenesis and the underlying biology of the infected pleural space. Geographical location and infection setting provide an insight of causative microorganism. Poor pleural fluid culture yields frequently necessitate prolonged courses of broad-spectrum antibiotics. With increased research and accessibility to molecular-based techniques, yields are expected to improve. The mainstays of treatment of pleural infection are prompt pleural fluid drainage, early initiation of antibiotics and nutrition support. Surgery and intrapleural enzyme therapy are required in over a third of patients and evolving paradigms toward earlier escalation of treatment are hoped to improve outcomes. The RAPID score has been driven and validated in numbers of studies, but it uses to direct patient treatment has not been explored.