21st February 2025

A 71-year-old man is admitted to hospital with a severe community-acquired pneumonia and initiated on intravenous antibiotics.

A 71-year-old man is admitted to hospital with a severe community-acquired pneumonia and initiated on intravenous antibiotics. Chest X-ray on admission demonstrates a left lower lobe pneumonia. Four days after admission he reports increasing breathlessness and reduced air entry at the left lung base is noted on examination. A repeat chest X-ray is carried out which demonstrates a new left-sided pleural effusion. 

The medical team decides to tap the effusion to guide ongoing management. 

Which of the following would be an indication for an urgent chest drain? 

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