Pleural Empyema pathophysiology

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Empyema Microchapters

Patient Information

Overview

Classification

Subdural empyema
Pleural empyema

Differential Diagnosis

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.[1] 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.[2]

References

  1. Strange C, Tomlinson JR, Wilson C, Harley R, Miller KS, Sahn SA (1989). "The histology of experimental pleural injury with tetracycline, empyema, and carrageenan". Exp Mol Pathol. 51 (3): 205–19. PMID 2480911.
  2. Ahmed SI, Gripaldo RE, Alao OA (2007). "Empyema necessitans in the setting of pneumonia and parapneumonic effusion". Am J Med Sci. 333 (2): 106–8. PMID 17301589.


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