Empyema - pleural; Pyothorax; Pleurisy - purulent
Empyema is a collection of pus in the space between the lung and the inner surface of the chest wall (pleural space).
Empyema is usually caused by an infection that spreads directly from the lung. It leads to a buildup of pus in the pleural space.
There can be 2 cups (1/2 liter) or more of infected fluid. This fluid puts pressure on the lungs.
Risk factors include:
In rare cases, empyema can occur after thoracentesis. This is a procedure in which a needle is inserted through the chest wall to remove fluid in the pleural space for medical diagnosis or treatment.
Symptoms of empyema may include any of the following:
Your health care provider may note decreased breath sounds or an abnormal sound (friction rub) when listening to your chest with a stethoscope (auscultation).
Tests that may be ordered include:
The goal of treatment is to cure the infection. This involves the following:
If you have problems breathing, you may need surgery to help your lung expand properly.
When empyema complicates pneumonia, the risk for permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage are needed.
In general, most people fully recover from empyema.
Having empyema may lead to the following:
Contact your provider if you develop symptoms of empyema.
Prompt and effective treatment of lung infections may prevent some cases of empyema.
Broaddus VC, Light RW. Pleural effusion. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 108.
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.BACK TO TOP
Review Date: 8/26/2023
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Health Content Provider
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2023 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.