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Empyema

Empyema - plural; Pyothorax; Pleurisy - purulent

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Causes

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 a pint (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.

Definition

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

Exams and Tests

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

Tests that may be ordered include:

Outlook (Prognosis)

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.

Possible Complications

Having empyema may lead to the following:

  • Pleural thickening
  • Reduced lung function

Prevention

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

Symptoms

Symptoms of empyema may include any of the following:

Treatment

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.

When to Contact a Medical Professional

Call your provider if you develop symptoms of empyema.

Review Date: 9/27/2017
Reviewed By: 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, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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