Empyema is a collection of pus in the space between the lung and the inner surface of the chest wall (pleural space).
Empyema - pleural; Pyothorax; Pleurisy - purulent
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 2 cups (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 remove fluid in the pleural space for medical diagnosis or treatment.
Symptoms of empyema may include any of the following:
The goal of treatment is to cure the infection. This involves the following:
If you have problems breathing, you may need surgery to help your lung expand properly.
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.
Having empyema may lead to the following:
Call your provider if you develop symptoms of empyema.
Prompt and effective treatment of lung infections may prevent some cases of empyema.
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-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 92.