Pleural Empyema pathophysiology
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Empyema Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
Pathophysiology
The process leading to the formation of empyema involves migration of organisms into the pleural cavity. This may be via direct extension/contiguous route. Contiguous infection {synpneumonic infection} leading to increased polymorphs to the pleura space and release of inflammatory cellular components and toxic oxygen species. This promotes endothelial injury resulting in increased pleural membrane permeability and increased osmotic pressure. The resultant empyema may spontaneously burrowed through the parietal pleura into the chest wall to form a subcutaneous abscess that may eventually rupture through the skin leading to formation of empyema necessitans.