Treat underlying disease
O2 if Hypoxemia
Perform thoracentesis vs. chest tube if evidence of respiratory distress
May need Video-Assisted Thoracic surgery (VATS)
Antibiotics
Piperacillin-tazobactam 3.375-4.5gm q6hr IV or imipenem 0.5-1gm q6hr
Consider adding vancomycin if patient at risk for MRSA
May need Video-Assisted Thoracic surgery (VATS)
Piperacillin-tazobactam 3.375-4.5gm q6hr IV or imipenem 0.5-1gm q6hr
Consider adding vancomycin if patient at risk for MRSA
Most spontaneous pneumothorax (primary and secondary)
Most iatrogenic pneumothorax
Alveolar-pleural fistulae (small air leak)
Iatrogenic air
Traumatic pneumothorax
Traumatic hemothorax ("any acute hemothorax visible on chest radiograph")
Pneumothorax on mechanical ventilation
Non-traumatic tension pneumothorax
Malignant effusion
Trauma/bleeding (hemothorax/hemopneumothorax)
Bronchial-pleural fistulae (large air leak)
Malignant fluid<unk> 
Thick pus
Empyema
Pneumonia
Atypical pneumonia
Sarcoidosis
Bronchiolitis 
Tuberculosis
Acute bronchitis
Pleural Effusion