Alteplase for Treatment of Empyema and Complicated Parapneumonic Effusion

Inclusion Criteria: * Ability to provide written informed consent * Age greater or equal to 18 yrs * Presence of empyema or CPE Exclusion Criteria: * Active internal bleeding * Pregnancy * Prior enrollment in this study * Platelet count less than 100,000/mm3 * Use of warfarin sodium if INR is greater than 1.7 * Use of heparin unless the PTT is less than 1.5 times baseline normal * Known neurological disorders * Current or pre-existing bleeding dyscrasia * Known allergy to Alteplase