Empyema

Emm-pie-ee-ma

by Cynthia M. Johnson, MA

Definition

Causes

Definition

An empyema is a pocket of pus outside the surface of the lung and inside the inner surface of the chest wall. The fluid may build up and put pressure on the lungs. This can make it hard to breath and may cause pain.

The Lungs (cut-away view)

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 weakened 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 may be:

Coughing
Problems breathing
Fever, chills, and sweating
Chest pain
Losing weight without trying

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

Pictures of the lungs and chest may be taken. This can be done with:

Thoracentesis may be done. A needle will be inserted through the chest wall and fluids will be collected for testing.

Treatment

Treatment options are:

Medication

Antibiotics will be given to treat the infection.

Procedures

Surgery may be done to drain the empyema. This can 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.

RESOURCES:

American College of Surgeons
https://www.facs.org

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

CANADIAN RESOURCES:

Canadian Association of Thoracic Surgeons
http://www.canadianthoracicsurgeons.ca

Health Canada
https://www.canada.ca

REFERENCES:

Empyema. NHS Choices website. Available at: http://www.nhs.uk/conditions/empyema/Pages/Introduction.aspx. Updated November 22, 2018. Accessed November 25, 2019.

Parapneumonic effusion and empyema in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/parapneumonic-effusion-and-empyema-in-adults. Updated June 14, 2017. Accessed November 25, 2019.

Pleural effusion and empyema. Mount Sinai Beth Israel Hospital website. Available at: https://www.mountsinai.org/locations/beth-israel/care/thoracic-surgery. Accessed November 25, 2019.

Yu H. Management of pleural effusion, empyema, and lung abscess. Semin Intervent Radiol. 2011 Mar;28(1):75-86.

Last reviewed September 2019 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 4/24/2020

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