Empyema
Definition
An empyema is a pocket of pus outside the lung and the inner surface of the chest wall. The fluid may build up and put pressure on the lungs. This can make it hard to breathe and may cause pain.
The Lungs (cut-away view) |
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Causes
Empyema is caused by a lung infection that spreads outside of the lung.
It can also happen after some chest procedures, such as thoracentesis.
Risk Factors
Things that may raise the risk of empyema are having:
- Lung infections, such as pneumonia
- A weak immune system, such as from HIV infection, steroid use, or cancer treatment
- Lung damage from things like chronic obstructive pulmonary disease, rheumatoid arthritis, or recent chest surgery
Symptoms
Symptoms of empyema may be:
- Coughing
- Problems breathing
- Fever, chills, and sweating
- Chest pain
- Losing weight without trying
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Pictures of the lungs and chest may be taken with:
- Chest x-ray
- Computed tomography (CT) scan
- Ultrasound
Thoracentesis may be done. A needle will be inserted through the chest wall. The needle collects fluids for testing.
Treatment
Antibiotics are given to treat the infection.
Surgery may be done to drain the empyema of infected fluid. It may be done with:
- Thoracentesis
- A chest tube
Diseased tissue and fluids may be removed with surgery. This can be done with video-assisted thoracoscopic surgery or thoracotomy.
Prevention
Get medical help right away for any symptoms of a lung infection.
References
- Empyema. NHS Choices website. Available at: https://www.nhs.uk/conditions/empyema.
- Godfrey MS, Bramley KT, Detterbeck F. Medical and Surgical Management of Empyema. Semin Respir Crit Care Med. 2019 Jun;40(3):361-374.
- Parapneumonic effusion and empyema in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/parapneumonic-effusion-and-empyema-in-adults.
- Pleural effusion and empyema. Mount Sinai Beth Israel Hospital website. Available at: https://www.mountsinai.org/locations/beth-israel/care/thoracic-surgery.