Learn About Empyema
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 directly from the lungs. It leads to a buildup of pus in the pleural space. 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.
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)
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 lungs expand properly.
Unity Urology PC
. Dr. Carter is rated as a Distinguished provider by MediFind in the treatment of Empyema. His top areas of expertise are Enlarged Prostate (BPH), UPJ Obstruction, Urinary Tract Infection in Children, Ureteroscopy, and Prostatectomy.
Ballad Health Medical Associates Urology
. Dr. Bauer is rated as a Distinguished provider by MediFind in the treatment of Empyema. His top areas of expertise are UPJ Obstruction, Boils, Kidney Stones, Ureteroscopy, and Prostatectomy.
Abingdon Ear, Nose, And Throat Associates, PC
. Dr. Neal is rated as a Distinguished provider by MediFind in the treatment of Empyema. His top areas of expertise are Grass Allergy, Allergic Rhinitis, Sinusitis, and Empyema.
When empyema complicates pneumonia, the risk for permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage is needed.
In general, most people fully recover from empyema.
Having empyema may lead to the following:
- Pleural thickening
- Reduced lung function
Contact your provider if you develop symptoms of empyema.
Prompt and effective treatment of lung infections may prevent some cases of empyema.
Background: Fungal empyema thoracis is a rare but life-threatening pleural infection caused by fungal organisms such as Aspergillus and Candida species. It typically occurs in immunocompromised or debilitated patients and carries a high mortality rate. Conventional management involves systemic antifungal therapy and surgical decortication; however, many patients are unfit for surgery due to poor clinical stat...
Summary: Chest tube thoracostomy remains a lifesaving intervention in trauma and thoracic surgery, used for the management of pneumothorax, hemothorax, empyema, and pleural effusions. Despite being one of the most frequently performed procedures worldwide, complication rates remain high, ranging from 20% to 40% \[1\]. Among these, pulmonary parenchymal chest tube (PPcT) insertion represents a rare but pote...
Published Date: August 05, 2025
Published By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.
Parta M, Nussenblatt V. Pleural effusion and empyema. In: Blaser MJ, Cohen JI, Holland SM, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2026:chap 70.