Empyema (accumulation of pus in the chest)

Chest | Pulmonology | Empyema (accumulation of pus in the chest) (Disease)


Empyema represents the presence of pus in the pleural space which is between the outer surface of the lung and the chest wall. The pus develops between the lung and the chest cavity where it can impair lung function. The bacteria causing the accumulation can cause damage to the body as well.

The formation of the empyema is conventionally divided into three phases: exudative, fibrinopurulent and organizing. During the exudative phase, the pus accumulates. This is followed by the fibrinopurulent phase in which there is loculation of the pleural fluid (the creation of grapelike pockets of pus). In the final organizing phase there is the potential for lung entrapment by scarring.

Symptoms of an empyema include fever, chills, and chest pain that worsens with deep breathing and is often worse on one side of the chest. Other symptoms include breathing difficulty, wheezing, and cough.

Causes and Risk factors

Empyema is often a complication of pneumonia caused by bacteria such as Streptococcus pneumonia, Staphylococcus aureus, or Haemophilus influenza (H. flu) type b

Diagnosis and Treatment

Treatment includes drainage of the pus will be done. This can be performed with a chest tube (thoracostomy). Occasionally the lining of the lung will need to be peeled away (decortication) as well. Antibiotics are given to kill the bacteria. ...