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Rebuttal From Dr Lai et alRebuttal From Dr Lai et al

Yu Kuang Lai, MD; Glenn Eiger, MD, FCCP; Robert A. Fischer, MD
Author and Funding Information

From the Department of Internal Medicine (Drs Lai and Eiger), and the Department of Infectious Disease (Dr Fischer), Einstein Medical Center.

CORRESPONDENCE TO: Yu Kuang Lai, MD, Department of Internal Medicine, Einstein Medical Center, 5501 Old York Rd, Klein 363, Philadelphia, PA 19141; e-mail: laijulie@einstein.edu


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):1210-1211. doi:10.1378/chest.15-0093
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Extract

The well-constructed argument of Dr Nguyen and colleagues1 that spontaneous bacterial empyema (SBEM) is essentially a complication of spontaneous bacterial peritonitis (SBP) consists of six points: (1) Both hepatic hydrothorax and SBEM occur mostly in the right lung, (2) ascitic fluid and pleural fluid in patients with cirrhosis have reduced opsonic activity, (3) SBEM is often caused by enteric organisms, (4) SBP may have been missed in some reports because of failure to culture in broth, (5) pneumonia may have been missed in some reports because of failure to obtain CT scan or ultrasonography, and (6) SBEM is a bad term because the infected fluid may be transudative.

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