Pleural empyema
| Pleural empyema | |
|---|---|
| Other names | Pyothorax, purulent pleuritis, lung empyema |
| CT chest showing large right sided hydro-pneumothorax from pleural empyema. Arrows A: air, B: fluid | |
| Specialty | Pulmonology, cardiothoracic surgery |
| Symptoms | Fever, chest pain with breathing in, cough, shortness of breath |
| Causes | Bacteria (often Strep. pneumonia) |
| Diagnostic method | Chest X-ray, Ultrasound, CT scan, thoracentesis |
| Differential diagnosis | Pneumonia, pleural effusion, pulmonary embolism |
| Treatment | Supportive care, antibiotics, surgery, chest tube |
Pleural empyema is a collection of pus in the pleural cavity. It is caused by microorganisms, usually bacteria. It often happens in the context of a pneumonia, injury, or chest surgery. It is one of the various kinds of pleural effusion. Pleural empyema contain three stages: exudative: when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent: when fibrous septa form localized pus pockets, and the final organizing stage: when there is scarring of the pleura membranes with possible inability of the lung to expand. Simple pleural effusions occur in up to 40% of bacterial pneumonias. They are usually small and resolve with appropriate antibiotic therapy. However, if an empyema develops additional intervention is required.