21st February 2025

A 53-year-old woman is brought to resus by ambulance after being found unwell and confused at home by her husband.

A 53-year-old woman is brought to resus by ambulance after being found unwell and confused at home by her husband. Her temperature is 38.4°C, heart rate 115 bpm, blood pressure 93/54 mmHg, oxygen saturations 90% on room air and respiratory rate 28/minute.

Her husband reports she was treated with antibiotics for a chest infection by her GP 2 weeks earlier but had never fully recovered and had been deteriorating at home over the last week.

A chest X-ray on admission demonstrates a large left-sided pleural effusion. After stabilising her with IV fluids and antibiotics, the medical team decides to take a diagnostic aspirate of the effusion. 

Which of the following findings would be diagnostic of an empyema?

Select the SINGLE most appropriate option from the list below. Select ONE option only.