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Dr Spernoga's letter describes the finding of empyema, which has not been previously reported in this disorder, to our knowledge; this adds another dimension to the disease.
However, again it should be emphasized that Gram's stain or culture of expectorated sputum cannot be solely relied on for the diagnosis of H parainfluenzae pneumonia, since this organism is commonly found in the upper respiratory tract and on the teeth. Retrieval of this organism from the blood, transtracheal aspirate, or pleural fluid, in addition to the sputum, would be necessary for the diagnosis, as was done in Dr Spernoga's patient.
Oill PA, Guze LB, Chow AW. Haemophilus parainfluenzae Pneumonia-Reply. Arch Intern Med. 1980;140(6):864. doi:10.1001/archinte.1980.00330180138046