Empyema
St. Luke's Hospital
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Empyema

Definition

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

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 or more of infected fluid. This fluid puts pressure on the lungs.

Risk factors include:

In rare cases, empyema can occur after a needle is inserted through the chest wall to draw off fluid in the pleural space for medical diagnosis or treatment (thoracentesis).

Symptoms

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 may include the following:

Treatment

The goal of treatment is to cure the infection and remove the collection of pus from the space between the lung and the inner surface of the chest wall. Antibiotics are prescribed to control the infection.

The health care provider will place a chest tube to completely drain the pus. A surgeon may need to perform a procedure to peel away the lining of the lung (decortication) if the lung does not expand properly.

Outlook (Prognosis)

When empyema complicates pneumonia, the risk of permanent lung damage and death goes up. Patients will need long-term treatment with antibiotics and drainage. However, most people fully recover from empyema.

Possible Complications

  • Pleural thickening
  • Reduced lung function

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of empyema.

Prevention

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

References

Celli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 100.

Broaddus VC, Light RW. Pleural effusion. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 68.



Review Date: 3/11/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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