What is empyema?

Empyema is a collection of pus in the cavity between the lung and the membrane that surrounds it (pleural space). Caused by an infection that spreads from the lung and leads to an accumulation of pus in the pleural space, the infected fluid can build up to a quantity of a pint or more, which puts pressure on the lungs, causing shortness of breath and pain. Risk factors include recent lung conditions like bacterial pneumonia, lung abscess, thoracic surgery, trauma or injury to the chest. 

Symptoms

• Dry cough 

• Fever and chills 

• Excessive sweating, especially night sweats 

• General discomfort, uneasiness or ill feeling (malaise) 

• Unintentional weight loss 

• Chest pain, which worsens on deep inhalation (inspiration) 

Diagnosis

The health care provider may note abnormal findings, such as decreased breath sounds or a friction rub, when listening to the chest with a stethoscope. Tests may include: 

• Chest X-ray

• Thoracentesis 

• Pleural fluid Gram stain and culture 

• CT scan of chest 

Treatment

The goal of treatment is to cure the infection and remove the collection of pus from the lung. Antibiotics are prescribed to control the infection. A doctor 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. 

Prognosis

Usually, empyema does not result in permanent pulmonary damage.