Pleural empyema
Pleural empyema is a collection of pus in the pleural cavity caused by microorganisms, usually bacteria. Often it happens in the context of a pneumonia, injury, or chest surgery. It is one of the various kinds of pleural effusion. There are 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. If however an empyema develops additional intervention is required.
| 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 |
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