Complicated Pneumonia

Abstract

Pneumonia is susceptible to present clinical deterioration classified as suppurated and nonsuppurated complications. Suppurated complications are more frequent in infants, especially in a population with no coverage of conjugate vaccines for Haemophilus influenzae and Streptococcus pneumoniae. These complications are related to the extension of infection, mainly to the pleura, with an increase of pleural fluid, and sometimes as an empyema, but also producing necrosis within the lung parenchyma, evolving to a localized abscess or necrotizing pneumonia. Complications cause prolonged hospitalization, sometimes surgery, but, under proper care, rarely death. Empyema has increased recently in relation to new Streptococcus pneumoniae strains, which are more invasive, but also to Staphylococcus aureus strains that are resistant to antibiotics. Diagnosis can be made by chest X-ray, but advances have been made using pleural ultrasound and chest computerized tomography.