Paediatric parapneumonic effusion/empyema
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Teaching point — how the wording changes the answer
A child with a week of pneumonia symptoms, chest recession and a right pleural effusion (costophrenic blunting) likely has a parapneumonic effusion/empyema. Pleural aspirate/thoracentesis is preferred as it is both diagnostic and therapeutic; avoid unnecessary CT radiation and invasive bronchoscopy.
Q34
Child with ~5-7 days of pneumonia, chest recessions and right pleural effusion. Most appropriate investigation?
Key clue
Diagnostic and therapeutic in one
Show answer
Pleural aspirate (thoracentesis)