| Risk Factors
An empyema is a pocket of pus outside the surface of the lung and the tissue that surrounds it. The fluid may build up in this space called the pleural space, and put pressure on the lungs. The pressure can make it difficult to breath and cause pain.
The Lungs (cut-away view)
Copyright © Nucleus Medical Media, Inc.
Empyema is caused by a lung infection, usually bacterial, that has traveled out of the lung. The most common infection associated with empyema is pneumonia, especially one that is difficult to treat.
Less often, empyema may develop after injury to lung tissue caused by chest trauma or medical procedures such as:
- Thoracentesis—a needle is inserted through the chest wall into the pleural space
- Chest surgery
Empyemas are more common in children and older people. They are also more common in men.
Factors that may increase the risk of empyema include lung infections, such as:
- Pneumonia (most common)
- Lung abscess
The risk of empyema may also increase in people who have a weakened immune system, such as with HIV infection, steroid use, and cancer treatment. Risk also increases with damage to lung tissue, which can occur with:
Symptoms may include:
- Fever, chills, and sweating
- Productive cough
- Chest pain
- Difficulty breathing
- Weight loss
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Thoracentesis—a sample of fluid taken from the area using a needle that is inserted through the chest wall
Your lungs and chest wall may need to be viewed. This can be done with:
- Chest x-ray
- CT scan
- Thoracoscopy—an instrument with a camera may be inserted into the chest to view the area
Talk with your doctor about the best treatment plan for you. Treatment includes:
Antibiotics by IV are used to treat the infection that causes the empyema.
Surgery may be need if the empyema does not resolve. This can be done using:
- Thoracentesis—A needle is inserted in the chest wall to drain the empyema.
- A chest tube—A tube is inserted in the chest wall to encourage the empyema to drain.
- Video-assisted thoracoscopic surgery (minimally invasive) or thoracotomy (open procedure)—The diseased lung tissue or fluids are surgically removed from the lung tissue and spaces.
To help reduce your chance of getting an empyema, seek medical help for any lung infections.
Empyema. Arkansas Children’s Hospital website. Available at: http://www.archildrens.org/documents/services/surgery/empyema.pdf. Accessed June 14, 2016.
Empyema. NHS Choices website. Available at: http://www.nhs.uk/conditions/empyema/Pages/Introduction.aspx. Updated February 11, 2016. Accessed June 14, 2016.
Parapneumonic effusion and empyema in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T435308/Parapneumonic-effusion-and-empyema-in-adults. Updated January 11, 2016. Accessed June 21, 2016.
Pleural effusion and empyema. Mount Sinai Beth Israel Hospital website. Available at: http://www.wehealny.org/services/Thoracic_Surgery/effusionAndEmpyema.html. Accessed June 14, 2016.
Last reviewed September 2016 by James Cornell, MD
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Information Services. All rights reserved.