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COUNTERPOINT: Does Spontaneous Bacterial Empyema Occur? NoDoes Spontaneous Bacterial Empyema Occur? No

Thien A. Nguyen, MD; Cesar Liendo, MD, FCCP; Michael W. Owens, MD
Author and Funding Information

From the Department of Pulmonary/Critical Care and Sleep Medicine, Louisiana State University, Health Sciences Center Shreveport.

CORRESPONDENCE TO: Michael W. Owens, MD, Louisiana State University, Health Sciences Center Shreveport, Department of Pulmonary/Critical Care and Sleep Medicine, 1501 Kings Highway, Shreveport, LA 71103; e-mail: Michael.Owens@va.gov


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(5):1208-1210. doi:10.1378/chest.15-0094
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Extract

Spontaneous bacterial empyema (SBEM) has been defined as a transudative pleural effusion with either a polymorphonuclear count that is > 500 cells/μL or a positive pleural fluid culture in patients without any radiographic evidence of pneumonia.1 It is reported to have an incidence of up to 15% in patients with cirrhosis and to have a mortality rate of up to 20%.2,3 This condition almost always is seen in patients with preexisting liver cirrhosis and secondary ascites. We believe that this condition is poorly defined and named, in that it is not spontaneous to the pleural space and it does not necessarily meet classic criteria of an empyema.

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