Pleural Effusion In Patients With Community Acquired Pneumonia

Introduction: The aim was to evaluate the clinical characteristics and evolution of community acquired pneumonia with associated paraneumonic pleural effusion(PE-CAP). Methods: Prospective observational study of all immunocompetent patients hospitalized for PE-CAP in our Pulmonology Service between 2005 and 2019.We considered PE-CAP when compatible radiology.Pleural effusion (PE) was classified as complicated based on its biochemical and/or radiological characteristics.Empyema criteria:macroscopic pus or germs in microbiological analysis of pleural fluid (PF). Results: 3417 patients, of which 221(6.5%) had PE. PF analysis was performed in 158 patients, of which in 134 cases the microbiology was negative and in 24 positive (9 Streptococcus spp.,8 S.pneumoniae,3 S.aureus,3 S.viridans,1 Eikinella corrodens). Bacteremia was observed in 34(15.4%) patients with PE: 31 cases S.pneumoniae,2 S.pyogenes and 1 S. viridans. Positive blood culture and positive microbiology of PF were observed in 4 patients (3 S.pneumoniae and 1 S.viridans). Conclusions: 6.5% of our patients had PE-CAP but only 1.9% complicated PE. Microbiological diagnosis was obtained in 15% of analyzed PF, and S. pneumoniae was the most frequent microorganism. Patients with CAP and PE were younger, less frequently vaccinated and with less comorbidities.They had more bacteremia, therapeutic failure,longer hospital stay,and later clinical stability, although they had similar mortality.