Skip to main content

Corticosteroids in Lung and Pleural Infections

Abstract

Purpose of Review

Despite modern healthcare practices and antimicrobial agents, community-acquired pneumonia (CAP) and associated parapneumonic effusion (PPE) are still common, associated with significant morbidity and mortality, and responsible for significant healthcare system costs globally. There is a need for adjunctive therapies to improve their clinical outcomes. The use of corticosteroids as an adjunctive therapy to suppress the inflammatory response in CAP has received significant attention.

Recent Findings

In this paper, we review in detail the randomized clinical trials to date on the use of corticosteroids in CAP.

Summary

Despite the large number of studies and optimism, the current evidence is inconclusive to warrant recommendation of the routine use of corticosteroids in CAP. The use of corticosteroid in PPE is also attracting interests which largely arose from indirect evidence. Direct placebo-controlled trials are required.

This is a preview of subscription content, access via your institution.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance ••Of major importance

  1. Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. Lancet. 2015;386(9998):1097–108. https://doi.org/10.1016/S0140-6736(15)60733-4.

    Article  PubMed  Google Scholar 

  2. • Wunderink RG, Waterer G. Advances in the causes and management of community acquired pneumonia in adults. BMJ. 2017;358:j2471. https://doi.org/10.1136/bmj.j2471. This paper provides a concise overview of the clinical issues with diagnosis and management of CAP

    Article  PubMed  Google Scholar 

  3. Wunderink RG, Waterer GW. Clinical practice. Community-acquired pneumonia. N Engl J Med. 2014;370(6):543–51. https://doi.org/10.1056/NEJMcp1214869.

    CAS  Article  PubMed  Google Scholar 

  4. WHO. The top 10 causes of death. 2017.

  5. Collaborators GBDCRD. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. https://doi.org/10.1016/S2213-2600(17)30293-X.

    Article  Google Scholar 

  6. Mandell LA, Wunderink RG, Waterer GW. Community-acquired pneumonia. N Engl J Med. 2015;372(3):293–4. https://doi.org/10.1056/NEJMc1414306#SA4.

    PubMed  Google Scholar 

  7. Antunes G, Evans SA, Lordan JL, Frew AJ. Systemic cytokine levels in community-acquired pneumonia and their association with disease severity. Eur Respir J. 2002;20(4):990–5. https://doi.org/10.1183/09031936.02.00295102.

    CAS  Article  PubMed  Google Scholar 

  8. Feldman C, Anderson R. Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials. J Thorac Dis. 2016;8(3):E162–71. https://doi.org/10.21037/jtd.2016.02.43.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wagner HN, Bennet IL, Lasagna L. The effect of hydrocortisone upon the course of pneumococcal pneumonia treated with penicillin. Bull Johns Hopkins Hosp. 1955;98:197–215.

    Google Scholar 

  10. Chalmers JD, Singanayagam A, Murray MP, Scally C, Fawzi A, Hill AT. Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia. Thorax. 2009;64(7):592–7. https://doi.org/10.1136/thx.2008.105080.

    CAS  Article  PubMed  Google Scholar 

  11. Dean NC, Griffith PP, Sorensen JS, McCauley L, Jones BE, Lee YC. Pleural effusions at first ED encounter predict worse clinical outcomes in patients with pneumonia. Chest. 2016;149(6):1509–15. https://doi.org/10.1016/j.chest.2015.12.027.

    Article  PubMed  Google Scholar 

  12. Kim J, Park JS, Cho YJ, Yoon HI, Lee JH, Lee CT, et al. Predictors of prolonged stay in patients with community-acquired pneumonia and complicated parapneumonic effusion. Respirology. 2016;21(1):164–71. https://doi.org/10.1111/resp.12658.

    Article  PubMed  Google Scholar 

  13. Light RW, Girard WM, Jenkinson SG, George RB. Parapneumonic effusions. Am J Med. 1980;69(4):507–12. https://doi.org/10.1016/0002-9343(80)90460-X.

    CAS  Article  PubMed  Google Scholar 

  14. Taryle DA, Potts DE, Sahn SA. The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. Chest. 1978;74(2):170–3. https://doi.org/10.1378/chest.74.2.170.

    CAS  Article  PubMed  Google Scholar 

  15. Ahmed RA, Marrie TJ, Huang JQ. Thoracic empyema in patients with community-acquired pneumonia. Am J Med. 2006;119(10):877–83. https://doi.org/10.1016/j.amjmed.2006.03.042.

    Article  PubMed  Google Scholar 

  16. Farjah F, Symons RG, Krishnadasan B, Wood DE, Flum DR. Management of pleural space infections: a population-based analysis. J Thorac Cardiovasc Surg. 2007;133(2):346–51. https://doi.org/10.1016/j.jtcvs.2006.09.038.

    Article  PubMed  Google Scholar 

  17. Corcoran JP, Wrightson JM, Belcher E, DeCamp MM, Feller-Kopman D, Rahman NM. Pleural infection: past, present, and future directions. Lancet Respir Med. 2015;3(7):563–77. https://doi.org/10.1016/S2213-2600(15)00185-X.

    Article  PubMed  Google Scholar 

  18. Ferguson AD, Prescott RJ, Selkon JB, Watson D, Swinburn CR. The clinical course and management of thoracic empyema. QJM. 1996;89(4):285–9. https://doi.org/10.1093/qjmed/89.4.285.

    CAS  Article  PubMed  Google Scholar 

  19. Hasley PB, Albaum MN, Li YH, Fuhrman CR, Britton CA, Marrie TJ, et al. Do pulmonary radiographic findings at presentation predict mortality in patients with community-acquired pneumonia? Arch Intern Med. 1996;156(19):2206–12. https://doi.org/10.1001/archinte.1996.00440180068008.

    CAS  Article  PubMed  Google Scholar 

  20. McHardy VU, Schonell ME. Ampicillin dosage and use of prednisolone in treatment of pneumonia: co-operative controlled trial. Br Med J. 1972;4(5840):569–73. https://doi.org/10.1136/bmj.4.5840.569.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Nafae RM, Ragab MI, Amany FM, Rashed SB. Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia. Egypt J Chest Dis Tuberc. 2013;62(3):439–45. https://doi.org/10.1016/j.ejcdt.2013.03.009.

    Article  Google Scholar 

  22. Marik P, Kraus P, Sribante J, Havlik I, Lipman J, Johnson DW. Hydrocortisone and tumor necrosis factor in severe community-acquired pneumonia. A randomized controlled study. Chest. 1993;104(2):389–92. https://doi.org/10.1378/chest.104.2.389.

    CAS  Article  PubMed  Google Scholar 

  23. Confalonieri M, Urbino R, Potena A, Piattella M, Parigi P, Puccio G, et al. Hydrocortisone infusion for severe community-acquired pneumonia: a preliminary randomized study. Am J Respir Crit Care Med. 2005;171(3):242–8. https://doi.org/10.1164/rccm.200406-808OC.

    Article  PubMed  Google Scholar 

  24. El-Ghamrawy AH, Shokeir MH, Esmat AA. Effects of low-dose hydrocortisone in ICU patients with severe community-acquired pneumonia. Egypt J Chest Dis Tuberc. 2006;55:91–9.

    Google Scholar 

  25. Mikami K, Suzuki M, Kitagawa H, Kawakami M, Hirota N, Yamaguchi H, et al. Efficacy of corticosteroids in the treatment of community-acquired pneumonia requiring hospitalization. Lung. 2007;185(5):249–55. https://doi.org/10.1007/s00408-007-9020-3.

    CAS  Article  PubMed  Google Scholar 

  26. Snijders D, Daniels JM, de Graaff CS, van der Werf TS, Boersma WG. Efficacy of corticosteroids in community-acquired pneumonia: a randomized double-blinded clinical trial. Am J Respir Crit Care Med. 2010;181(9):975–82. https://doi.org/10.1164/rccm.200905-0808OC.

    CAS  Article  PubMed  Google Scholar 

  27. Fernandez-Serrano S, Dorca J, Garcia-Vidal C, Fernandez-Sabe N, Carratala J, Fernandez-Aguera A, et al. Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial. Crit Care. 2011;15(2):R96. https://doi.org/10.1186/cc10103.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Meijvis SC, Hardeman H, Remmelts HH, Heijligenberg R, Rijkers GT, van Velzen-Blad H, et al. Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. Lancet. 2011;377(9782):2023–30. https://doi.org/10.1016/S0140-6736(11)60607-7.

    CAS  Article  PubMed  Google Scholar 

  29. Sabry NAO, E.E. Corticosteroids and ICU course of community acquired pneumonia in Egyptian settings. Pharmacol Pharm. 2011;2(02):73–81. https://doi.org/10.4236/pp.2011.22009.

    CAS  Article  Google Scholar 

  30. Blum CA, Nigro N, Briel M, Schuetz P, Ullmer E, Suter-Widmer I, et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2015;385(9977):1511–8. https://doi.org/10.1016/S0140-6736(14)62447-8.

    CAS  Article  PubMed  Google Scholar 

  31. Torres A, Sibila O, Ferrer M, Polverino E, Menendez R, Mensa J, et al. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA. 2015;313(7):677–86. https://doi.org/10.1001/jama.2015.88.

    CAS  Article  PubMed  Google Scholar 

  32. Bi J, Yang J, Wang Y, Yao C, Mei J, Liu Y, et al. Efficacy and safety of adjunctive corticosteroids therapy for severe community-acquired pneumonia in adults: an updated systematic review and meta-analysis. PLoS One. 2016;11(11):e0165942. https://doi.org/10.1371/journal.pone.0165942.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Chen LP, Chen JH, Chen Y, Wu C, Yang XH. Efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. World J Emerg Med. 2015;6(3):172–8. https://doi.org/10.5847/wjem.j.1920-8642.2015.03.002.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Cheng M, Pan ZY, Yang J, Gao YD. Corticosteroid therapy for severe community-acquired pneumonia: a meta-analysis. Respir Care. 2014;59(4):557–63. https://doi.org/10.4187/respcare.02758.

    Article  PubMed  Google Scholar 

  35. Horita N, Otsuka T, Haranaga S, Namkoong H, Miki M, Miyashita N, et al. Adjunctive systemic corticosteroids for hospitalized community-acquired pneumonia: systematic review and meta-analysis 2015 update. Sci Rep. 2015;5(1):14061. https://doi.org/10.1038/srep14061.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  36. Marti C, Grosgurin O, Harbarth S, Combescure C, Abbas M, Rutschmann O, et al. Adjunctive corticotherapy for community acquired pneumonia: a systematic review and meta-analysis. PLoS One. 2015;10(12):e0144032. https://doi.org/10.1371/journal.pone.0144032.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Nie W, Zhang Y, Cheng J, Xiu Q. Corticosteroids in the treatment of community-acquired pneumonia in adults: a meta-analysis. PLoS One. 2012;7(10):e47926. https://doi.org/10.1371/journal.pone.0047926.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  38. Shafiq M, Mansoor MS, Khan AA, Sohail MR, Murad MH. Adjuvant steroid therapy in community-acquired pneumonia: a systematic review and meta-analysis. J Hosp Med. 2013;8(2):68–75. https://doi.org/10.1002/jhm.1992.

    Article  PubMed  Google Scholar 

  39. Siemieniuk RA, Meade MO, Alonso-Coello P, Briel M, Evaniew N, Prasad M, et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med. 2015;163(7):519–28. https://doi.org/10.7326/M15-0715.

    Article  PubMed  Google Scholar 

  40. Wan YD, Sun TW, Liu ZQ, Zhang SG, Wang LX, Kan QC. Efficacy and safety of corticosteroids for community-acquired pneumonia: a systematic review and meta-analysis. Chest. 2016;149(1):209–19. https://doi.org/10.1378/chest.15-1733.

    Article  PubMed  Google Scholar 

  41. Wu WF, Fang Q, He GJ. Efficacy of corticosteroid treatment for severe community-acquired pneumonia: a meta-analysis. Am J Emerg Med. 2017; https://doi.org/10.1016/j.ajem.2017.07.050.

  42. •• Waterer G. Systemic corticosteroids and community-acquired pneumonia-cautious optimism or wishful thinking? J Thorac Dis. 2015;7(12):E622–4. https://doi.org/10.3978/j.issn.2072-1439.2015.12.22. This paper provides a good perspective of the issues with corticosteroid use in CAP

    PubMed  PubMed Central  Google Scholar 

  43. Chalmers JD. Corticosteroids for community-acquired pneumonia: a critical view of the evidence. Eur Respir J. 2016;48(4):984–6. https://doi.org/10.1183/13993003.01329-2016.

    Article  PubMed  Google Scholar 

  44. Finfer S. Clinical controversies in the management of critically ill patients with severe sepsis: resuscitation fluids and glucose control. Virulence. 2014;5(1):200–5. https://doi.org/10.4161/viru.25855.

    Article  PubMed  Google Scholar 

  45. Nie S, Tang L, Zhang W, Feng Z, Chen X. Are there modifiable risk factors to improve AKI? Biomed Res Int. 2017;2017:5605634. https://doi.org/10.1155/2017/5605634.

    Article  PubMed  PubMed Central  Google Scholar 

  46. van Vught LA, Wiewel MA, Klein Klouwenberg PM, Hoogendijk AJ, Scicluna BP, Ong DS, et al. Admission hyperglycemia in critically ill sepsis patients: association with outcome and host response. Crit Care Med. 2016;44(7):1338–46. https://doi.org/10.1097/CCM.0000000000001650.

    Article  PubMed  Google Scholar 

  47. Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415. https://doi.org/10.1136/bmj.j1415.

    Article  PubMed  Google Scholar 

  48. Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam J, Lim WS. Corticosteroids as adjunctive therapy in the treatment of influenza. Cochrane Database Syst Rev. 2016;3:CD010406. https://doi.org/10.1002/14651858.CD010406.pub2.

    PubMed  Google Scholar 

  49. Grijalva CG, Zhu Y, Nuorti JP, Griffin MR. Emergence of parapneumonic empyema in the USA. Thorax. 2011;66(8):663–8. https://doi.org/10.1136/thx.2010.156406.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Li ST, Tancredi DJ. Empyema hospitalizations increased in US children despite pneumococcal conjugate vaccine. Pediatrics. 2010;125(1):26–33. https://doi.org/10.1542/peds.2009-0184.

    Article  PubMed  Google Scholar 

  51. Antony VB, Godbey SW, Kunkel SL, Hott JW, Hartman DL, Burdick MD, et al. Recruitment of inflammatory cells to the pleural space. Chemotactic cytokines, IL-8, and monocyte chemotactic peptide-1 in human pleural fluids. J Immunol. 1993;151(12):7216–23.

    CAS  PubMed  Google Scholar 

  52. Heumann D, Barras C, Severin A, Glauser MP, Tomasz A. Gram-positive cell walls stimulate synthesis of tumor necrosis factor alpha and interleukin-6 by human monocytes. Infect Immun. 1994;62(7):2715–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Kroegel C, Antony VB. Immunobiology of pleural inflammation: potential implications for pathogenesis, diagnosis and therapy. Eur Respir J. 1997;10(10):2411–8. https://doi.org/10.1183/09031936.97.10102411.

    CAS  Article  PubMed  Google Scholar 

  54. Sahn SA. Management of complicated parapneumonic effusions. Am Rev Respir Dis. 1993;148(3):813–7. https://doi.org/10.1164/ajrccm/148.3.813.

    CAS  Article  PubMed  Google Scholar 

  55. Sahn SA. Diagnosis and management of parapneumonic effusions and empyema. Clin Infect Dis. 2007;45(11):1480–6. https://doi.org/10.1086/522996.

    CAS  Article  PubMed  Google Scholar 

  56. Allen JC, Apicella MA. Experimental pleural effusion as a manifestation of delayed hypersensitivity to tuberculin PPD. J Immunol. 1968;101(3):481–7.

    CAS  PubMed  Google Scholar 

  57. Antony VB, Rothfuss KJ, Godbey SW, Sparks JA, Hott JW. Mechanism of tetracycline-hydrochloride-induced pleurodesis. Tetracycline-hydrochloride-stimulated mesothelial cells produce a growth-factor-like activity for fibroblasts. Am Rev Respir Dis. 1992;146(4):1009–13. https://doi.org/10.1164/ajrccm/146.4.1009.

    CAS  Article  PubMed  Google Scholar 

  58. Cabellos C, MacIntyre DE, Forrest M, Burroughs M, Prasad S, Tuomanen E. Differing roles for platelet-activating factor during inflammation of the lung and subarachnoid space. The special case of Streptococcus pneumoniae. J Clin Invest. 1992;90(2):612–8. https://doi.org/10.1172/JCI115900.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  59. Fujiwara H, Tsuyuguchi I. Frequency of tuberculin-reactive T-lymphocytes in pleural fluid and blood from patients with tuberculous pleurisy. Chest. 1986;89(4):530–2. https://doi.org/10.1378/chest.89.4.530.

    CAS  Article  PubMed  Google Scholar 

  60. Idell S, Zwieb C, Kumar A, Koenig KB, Johnson AR. Pathways of fibrin turnover of human pleural mesothelial cells in vitro. Am J Respir Cell Mol Biol. 1992;7(4):414–26. https://doi.org/10.1165/ajrcmb/7.4.414.

    CAS  Article  PubMed  Google Scholar 

  61. Philip-Joet F, Alessi MC, Philip-Joet C, Aillaud M, Barriere JR, Arnaud A, et al. Fibrinolytic and inflammatory processes in pleural effusions. Eur Respir J. 1995;8(8):1352–6. https://doi.org/10.1183/09031936.95.08081352.

    CAS  Article  PubMed  Google Scholar 

  62. Ribera E, Espanol T, Martinez-Vazquez JM, Ocana I, Encabo G. Lymphocyte proliferation and gamma-interferon production after “in vitro” stimulation with PPD. Differences between tuberculous and nontuberculous pleurisy in patients with positive tuberculin skin test. Chest. 1990;97(6):1381–5. https://doi.org/10.1378/chest.97.6.1381.

    CAS  Article  PubMed  Google Scholar 

  63. Ribera E, Ocana I, Martinez-Vazquez JM, Rossell M, Espanol T, Ruibal A. High level of interferon gamma in tuberculous pleural effusion. Chest. 1988;93(2):308–11. https://doi.org/10.1378/chest.93.2.308.

    CAS  Article  PubMed  Google Scholar 

  64. Valdes L, San Jose E, Alvarez D, Sarandeses A, Pose A, Chomon B, et al. Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma. Chest. 1993;103(2):458–65. https://doi.org/10.1378/chest.103.2.458.

    CAS  Article  PubMed  Google Scholar 

  65. Villena V, Lopez-Encuentra A, Echave-Sustaeta J, Martin-Escribano P, Ortuno-de-Solo B, Estenoz-Alfaro J. Interferon-gamma in 388 immunocompromised and immunocompetent patients for diagnosing pleural tuberculosis. Eur Respir J. 1996;9(12):2635–9. https://doi.org/10.1183/09031936.96.09122635.

    CAS  Article  PubMed  Google Scholar 

  66. Barnes PF, Fong SJ, Brennan PJ, Twomey PE, Mazumder A, Modlin RL. Local production of tumor necrosis factor and IFN-gamma in tuberculous pleuritis. J Immunol. 1990;145(1):149–54.

    CAS  PubMed  Google Scholar 

  67. Soderblom T, Nyberg P, Teppo AM, Klockars M, Riska H, Pettersson T. Pleural fluid interferon-gamma and tumour necrosis factor-alpha in tuberculous and rheumatoid pleurisy. Eur Respir J. 1996;9(8):1652–5. https://doi.org/10.1183/09031936.96.09081652.

    CAS  Article  PubMed  Google Scholar 

  68. Barnes PJ. How corticosteroids control inflammation: Quintiles Prize Lecture 2005. Br J Pharmacol. 2006;148(3):245–54. https://doi.org/10.1038/sj.bjp.0706736.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  69. Rosewicz S, McDonald AR, Maddux BA, Goldfine ID, Miesfeld RL, Logsdon CD. Mechanism of glucocorticoid receptor down-regulation by glucocorticoids. J Biol Chem. 1988;263(6):2581–4.

    CAS  PubMed  Google Scholar 

  70. Scheinman RI, Cogswell PC, Lofquist AK, Baldwin AS Jr. Role of transcriptional activation of I kappa B alpha in mediation of immunosuppression by glucocorticoids. Science. 1995;270(5234):283–6. https://doi.org/10.1126/science.270.5234.283.

    CAS  Article  PubMed  Google Scholar 

  71. Luo Z, Luo J, Liu E, Xu X, Liu Y, Zeng F, et al. Effects of prednisolone on refractory mycoplasma pneumoniae pneumonia in children. Pediatr Pulmonol. 2014;49(4):377–80. https://doi.org/10.1002/ppul.22752.

    Article  PubMed  Google Scholar 

  72. Shan LS, Liu X, Kang XY, Wang F, Han XH, Shang YX. Effects of methylprednisolone or immunoglobulin when added to standard treatment with intravenous azithromycin for refractory mycoplasma pneumoniae pneumonia in children. World J Pediatr. 2017;13(4):321–7. https://doi.org/10.1007/s12519-017-0014-9.

    CAS  Article  PubMed  Google Scholar 

  73. Sellares J, Lopez-Giraldo A, Lucena C, Cilloniz C, Amaro R, Polverino E, et al. Influence of previous use of inhaled corticoids on the development of pleural effusion in community-acquired pneumonia. Am J Respir Crit Care Med. 2013;187(11):1241–8. https://doi.org/10.1164/rccm.201209-1732OC.

    Article  PubMed  Google Scholar 

  74. • Tagarro A, Otheo E, Baquero-Artigao F, Navarro ML, Velasco R, Ruiz M, et al. Dexamethasone for parapneumonic pleural effusion: a randomized, double-blind, clinical trial. J Pediatr. 2017;185:117–123.e6. https://doi.org/10.1016/j.jpeds.2017.02.043. This is one of the first RCTs looking at the use of corticosteroids in PPE.

    CAS  Article  PubMed  Google Scholar 

Download references

Acknowledgments

Thanks to Dr. Shirin Shafazand, Editor in Chief, who helped with the review of this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Y. C. Gary Lee.

Ethics declarations

Conflict of Interest

Ka Pang Chan, Yun Chor Lee, Arash Badiei, and Grant Waterer declare no conflict of interest. Dr. Lee is the section editor of the Pleural Diseases and Mesothelioma section.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Pleural Diseases and Mesothelioma

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Badiei, A., Chan, K.P., Lee, Y.C.G. et al. Corticosteroids in Lung and Pleural Infections. Curr Pulmonol Rep 7, 19–27 (2018). https://doi.org/10.1007/s13665-018-0197-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13665-018-0197-0

Keywords

  • Pneumonia
  • Pleural effusion
  • Empyema
  • Steroid