It is paradoxical that Hippocrates established in ancient timesthe clinical importance of pleural infections, yet only a fewhigh-quality trials have studied this common condition duringthe intervening 2400 years. Just five years ago, published guidelinesfor the management of empyema1 could identify only three relevantcontrolled trials, with a combined enrollment of fewer than100 patients. This lack of evidence results partly from difficultiesthat are inherent in investigating pleural infections, whichrepresent heterogeneous disorders with outcomes strongly influencedby multiple factors that include coexisting illnesses, underlyinglung function, the severity of associated pneumonia, the extentof pleural . . . [Full Text of this Article]
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From the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston.
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