Learn About Empyema

What is the definition of Empyema?

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

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What are the alternative names for Empyema?

Empyema - pleural; Pyothorax; Pleurisy - purulent

What are the causes of Empyema?

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

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

Risk factors include:

  • Bacterial pneumonia
  • Tuberculosis
  • Chest surgery
  • Lung abscess
  • Trauma or injury to the chest

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

What are the symptoms of Empyema?

Symptoms of empyema may include any of the following:

  • Chest pain, which worsens when you breathe in deeply (pleurisy)
  • Dry cough
  • Excessive sweating, especially night sweats
  • Fever and chills
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Shortness of breath
  • Weight loss (unintentional)
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What are the current treatments for Empyema?

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.

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What is the outlook (prognosis) for Empyema?

When empyema complicates pneumonia, the risk for permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage are needed.

In general, most people fully recover from empyema.

What are the possible complications of Empyema?

Having empyema may lead to the following:

  • Pleural thickening
  • Reduced lung function
When should I contact a medical professional for Empyema?

Contact your provider if you develop symptoms of empyema.

How do I prevent Empyema?

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

Chest tube insertion - series - Pleural cavity
What are the latest Empyema Clinical Trials?
Role of Indocyanine Green in Visualizing Critical View of Safety During Laparoscopic Cholecystectomy for Acute Cholecystitis

Summary: The purpose of this prospective randomized trial is to study the role of Indocyanine green (ICG) to visualize the Critical View of Safety during emergency Laparoscopic Cholecystectomy for patients with Acute Cholecystitis.

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Fetal Outcomes Among Pregnant Emergency General Surgery Patients: a Prospective Multi-center Evaluation of Pregnant Patients Undergoing Emergency General Surgery

Summary: Approximately 1 in 500 pregnant women require non-obstetric surgery. Surgical care for the pregnant woman raises concern for complications adversely affecting pregnancy outcomes. The most common reason for surgery is acute appendicitis followed by gallbladder disease. Despite the common incidence of non-obstetric surgery among pregnant women, little is known regarding fetal outcome and the impact ...

What are the Latest Advances for Empyema?
Surfactant for a Patient with Refractory Pyopneumothorax and Acute Respiratory Distress Syndrome Due to Pneumococcal Necrotizing Pneumonia Complicated by a Bronchopleural Fistula.
A feasibility randomised trial comparing therapeutic thoracentesis to chest tube insertion for the management of pleural infection: results from the ACTion trial.
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Cholecystocolic fistula closed using endoscopic therapy alone: A case report.
Who are the sources who wrote this article ?

Published Date: September 01, 2021
Published By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Broaddus VC, Light RW. Pleural effusion. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 108.

McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 92.