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Empyema

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Contents of this page:

Illustrations

Lungs
Lungs
Respiratory system
Respiratory system
Chest tube insertion  - series
Chest tube insertion - series

Definition    Return to top

Empyema is a collection of pus in the cavity between the lung and the membrane that surrounds it (pleural space).

Causes    Return to top

Empyema is caused by an infection that spreads from the lung and leads to an accumulation of pus in the pleural space. The infected fluid can build up to a quantity of a pint or more, which puts pressure on the lungs, causing shortness of breath and pain.

Risk factors include recent pulmonary (lung) conditions including bacterial pneumonia, lung abscess, thoracic surgery, trauma or injury to the chest, or rarely, a needle inserted through the chest wall to draw off fluid in the pleural space (thoracentesis).

Symptoms    Return to top

Exams and Tests    Return to top

The health care provider may note abnormal findings, such as decreased breath sounds or a friction rub, when listening to the chest with a stethoscope (auscultation).

Tests may include the following:

Treatment    Return to top

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. A doctor 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.

Outlook (Prognosis)    Return to top

Usually, empyema does not result in permanent pulmonary damage.

Possible Complications    Return to top

A possible complication is pleural thickening.

When to Contact a Medical Professional    Return to top

Call your health care provider if you develop symptoms of empyema.

Prevention    Return to top

Prompt treatment of pulmonary (lung) infections may prevent some cases of empyema.

References    Return to top

Mason RJ, Broaddus VC, Murray JF, Nadel JA. Murray and Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders; 2005.

Ahmed RA, Marrie TJ, Huang JQ. Thoracic empyema in patients with community-acquired pneumonia. Am J Med. October 2006;119:877-883.

Qureshi NR, Gleeson FV. Imaging of Pleural Disease. Clin Chest Med. June 2006;27:193-213.

Update Date: 3/1/2007

Updated by: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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