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Empyema

  • Definition
    • Empyema is a collection of pus in the space between the lung and the inner surface of the chest wall (pleural space).

      Lungs
  • Alternative Names
    • Empyema - plural; Pyothorax; Pleurisy - purulent

  • Causes
    • Empyema is usually caused by an infection that spreads from the lung. It leads to a buildup of pus in the pleural space.

      There can be a pint (1/2 liter) or more of infected fluid. This fluid puts pressure on the lungs.

      Risk factors include:

      In rare cases, empyema can occur after thoracentesis. This is a procedure in which a needle is inserted through the chest wall to draw off fluid in the pleural space for medical diagnosis or treatment.

  • Symptoms
  • Exams and Tests
  • Treatment
    • The goal of treatment is to cure the infection. This involves the following:

      • Placing a tube in your chest to drain the pus
      • Giving you antibiotics to control the infection

      If you have problems breathing, you may need surgery to help your lung expand properly.

  • Outlook (Prognosis)
    • When empyema complicates pneumonia, the risk of permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage are needed.

      In general, most people fully recover from empyema.

  • Possible Complications
    • Having empyema may lead to the following:

      • Pleural thickening
      • Reduced lung function
  • When to Contact a Medical Professional
    • Call your health care provider if you develop symptoms of empyema.

  • Prevention
    • Prompt and effective treatment of lung infections may prevent some cases of empyema.

  • References
    • Broaddus VC, Light RW. Pleural effusion. In: Broaddus VC, Mason RJ, Ernst JD, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.

      McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 99.