Pleural empyema | |
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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 caused by microorganisms, usually bacteria.[1] Often it happens in the context of a pneumonia, injury, or chest surgery.[1] 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.