Empyema is a collection of pus in the space between the lung and the inside of the chest wall (pleural space).
Causes, incidence, and risk factorsEmpyema is 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 or more of infected fluid. This fluid puts pressure on the lungs.
Risk factors include:
In rare cases, empyema can occur when a needle is inserted through the chest wall to draw off fluid in the pleural space (thoracentesis)
SymptomsThe health care provider may note decreased breath sounds or a friction rub when listening to the chest with a stethoscope (auscultation).
Tests may include the following:
The goal of treatment is to cure the infection and remove the collection of pus from the lung. Antibiotics are prescribed to control the infection.
The health care provider will place a chest tube to completely drain the pus. A surgeon may need to perform a procedure to peel away the lining of the lung (decortication) if the lung does not expand properly.
Expectations (prognosis)When empyema complicates pneumonia, the risk of permanent lung damage and death goes up. Patients will need long-term treatment with antibiotics and drainage. However, most people fully recover from empyema.
ComplicationsCall your health care provider if you develop symptoms of empyema.
PreventionPrompt and effective treatment of lung infections may prevent some cases of empyema.
ReferencesCelli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 100.
Mason RJ, Broaddus VC, Murray JF, Nadel JA. Pleural effusion. In: Mason RJ, Broaddus VC, Murray JF, Nadel JA, eds. Murray and Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2005:chap 68.
Empyema is a collection of pus in the space between the lung and the inner surface of the chest wall (pleural space).
Causes, incidence, and risk factorsEmpyema 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 or more of infected fluid. This fluid puts pressure on the lungs.
Risk factors include:
In rare cases, empyema can occur after a needle is inserted through the chest wall to draw off fluid in the pleural space for medical diagnosis or treatment (thoracentesis).
SymptomsThe health care provider may note decreased breath sounds or an abnormal sound (friction rub) when listening to the chest with a stethoscope (auscultation).
Tests may include the following:
The goal of treatment is to cure the infection and remove the collection of pus from the space between the lung and the inner surface of the chest wall. Antibiotics are prescribed to control the infection.
The health care provider will place a chest tube to completely drain the pus. A surgeon may need to perform a procedure to peel away the lining of the lung (decortication) if the lung does not expand properly.
Expectations (prognosis)When empyema complicates pneumonia, the risk of permanent lung damage and death goes up. Patients will need long-term treatment with antibiotics and drainage. However, most people fully recover from empyema.
ComplicationsCall your health care provider if you develop symptoms of empyema.
PreventionPrompt and effective treatment of lung infections may prevent some cases of empyema.
ReferencesCelli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 100.
Broaddus VC, Light RW. Pleural effusion. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 68.
Reviewed ByReview Date: 03/11/2011
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Empyema in the pleural cavity is sometimes called empyema thoracis, or empyema of the chest
Empyema in the pleural cavity or empyema of the chest
Empyema is treated using a combination of medications and surgical techniques
The signs and symptoms of empyema vary somewhat according to the location of the infection and its severity
The diagnosis of empyema is usually confirmed by analyzing a sample of fluid taken from the pleural cavity
empyema
Pelvic empyema in women is most often caused by Bacteroides strains or Pseudomonas aeruginosa
Patients with thoracic empyema may develop potentially life-threatening complications if the condition is not treated
On an x ray, empyema thoracis will appear as a cloudy or opaque ar
Carl Arthur Hedblom has written: 'The treatment of chronic empyema' -- subject(s): Empyema
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In pelvic empyema, the infection produces large amounts of thick, foul-smelling pus that is rapidly replaced even after drainage