This tool supports structured infectious-disease decision making but does not replace clinician judgement or local guideline pathways.
This OpiCalc infectious-disease entry reflects commonly used guideline criteria and bedside risk features used in contemporary clinical practice.
Parapneumonic pH Management: Pleural fluid pH helps determine when drainage should supplement antibiotics.
Pleural pH <7.20
+3 Points
Frank pus or positive Gram/culture
Loculated effusion
+2 Points
Pleural glucose low
+1 Points
Large or expanding effusion
Persistent sepsis despite antibiotics
Assessment Tier
Score 0
Selected profile is less compelling for immediate drainage.