Pneumonia - Surgery


An in-depth report on the causes, diagnosis, treatment, and prevention of pneumonia.


Although most patients with pneumonia do not need invasive therapy, it may be necessary in patients with abscesses, empyema, or certain other complications.


Thoracotomy is the standard surgery for pneumonia. It requires general anesthesia and an incision to open the chest and view the lungs. This procedure allows the surgeon to remove dead or damaged lung tissue. In severe cases, the entire lobe of the lung is removed. This is called a lobectomy. Remaining healthy lung tissue re-expands after surgery to make up for tissue that has been removed.

Chest Tubes

Chest tubes are used to drain infected pleural fluid. Tubes are not typically required for pneumonia or abscesses. The tubes are inserted after the patient is given a local anesthetic. They remain in place for 2 - 4 days, and are removed in one quick movement. This can be very distressing, although some patients experience no discomfort. Complications of chest tubes include:

  • Accidental injury to the lung
  • Fluid build-up within the lung if the pleural fluid is removed too rapidly
  • Infection
  • Perforation of the diaphragm

Removing the chest tubes may cause the lung to collapse. In this case, a chest tube may be needed to inflate the lung.

Chest tube insertion - series
Click the icon to see an illustrated series detailing chest tube insertion.



American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents -- United States, 2008. Pediatrics. 2008;121:219-220.

Barr CE, Schulman K, Iacuzio D, Bradley JS. Effect of oseltamivir on the risk of pneumonia and use of health care services in chidlren with clinically diagnosed influenza. Curr Med Res Opin. 2007;23(3):523-531.

Galobardes B, McCarron P, Jeffreys M, Davey-Smith G. Medical history of respiratory disease in early life relates to morbidity and mortality in adulthood. Thorax. 2008;Epub.

Gleason PP, Shaughnessy AF. STEPS new drug reviews telithromycin (Ketek) for treatment of community-acquired pneumonia. Am Fam Physician. 2007;76.

Grijalva CG, Nuorti JP, Arbogast PG, Martin SW, Edwards KM, Griffin MR. Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time-series analysis. Lancet. 2007;369:1179-1186.

Grijalva CG, et al. Pneumonia hospitalizations among young children before and after introduction of pneumococcal conjugate vaccine -- United States, 1997 - 2006. MMWR. 2009;58:1-4.

Huss A, Scott P, Stuck AE, Trotter C, Egger M. Efficacy of pneumococcal vaccination in adults: a meta-analysis. CMAJ. 2009;180:48-58.

Jackson M, Nelson JC, Weiss NS, Neuzil KM, Barlow W, Jackson LA. Influenza vaccination and risk of community-acquired pneumonia in immunocompetent elderly people: A population-based, nested case-control study. Lancet. 2008;372:352-354.

Johnstone J, Marrie TJ, Eurich DT, Majumdar SR. Effect of pneumococcal vaccine in hospitalized adults with community-acquired pneumonia. Arch Intern Med. 2007;167:1938-1943.

Knol W, van Marum RJ, Jansen PA, Souverein PC, Schobben AF, Egberts AC. Antipsychotic drug use and risk of pneumonia in elderly people. J Am Geriatr Soc. 2008;56:661-666.

Kollef MH, Afessa B, Anzueto A, Veremakis C, Kerr KM, Margolis BD, et al. Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: The NASCENT randomized trial. JAMA. 2008;300:805-813.

Lee TA, Weaver FM, Weiss KB. Impact of pneumococcal vaccination on pneumonia rates in patients with COPD and asthma. J Gen Intern Med. 2007;22(1):62-67.

Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2007;120:783-790.

Limper AH. Overview of Pneumonia. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. Philadelphia, Pa: Saunders; 2007:chap 97.

Lutfiyya MN, Henley E, Chang LF. Diagnosis and treatment of community-acquired pneumonia. Am Fam Physician. 2006;73:442-450.

Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44:S27-S72.

Meissner HC, Long SS. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics. 2003;112:1447-1452.

Muller B, Harbath S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis. 2007;7:10.

Neuman MI, Willett WC, Curhan GC. Vitamin and micronutrient intake and the risk of community-acquired pneumonia in US women. Am J Med. 2007;120:330-336.

Nisar N, Guleria R, Kuman S, Chand Chawla T, Ranjan Biswas N. Mycoplasma pneumoniae and its role in asthma. Postgrad Med J. 2007;83:100-104.

Reade MC, Yende S, DAngelo G, Milbrandt EB, Kellum JA, Bamato AE, et al. Sex disparities in treatment and outcome of community-acquired pneumonia. Am J Respir Crit Care Med. 2008;177:A770.

Sing S, Amin AV, Loke YK. Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: A meta-analysis. Arch Intern Med. 2009;169:219-229.

Spaude KA, Abrutyn E, Kirchner C, Kim A, Daley J, Fisman DN. Influenza vaccination and risk of mortality among adults hospitalized with community-acquired pneumonia. Arch Intern Med 2007;167(1):53-59.

Venditti M, Falcone M, Corrao S, Licata G, Serra P. Outcomes of patients hospitalized with community-acquired, health-care associated, and hospital-acquired pneumonia. Ann Intern Med. 2009;150:19-26.

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