Empyema

Empyema
ICD-10	J86
ICD-9	510
DiseasesDB	4200
MedlinePlus	000123
MeSH	D016724

Empyema Microchapters
Patient Information
Overview
Classification Subdural empyema Pleural empyema
Differential Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Pyothorax

Pleural space empyema

Symptoms

Symptoms of empyema may vary in severity. Typical symptoms include: fever, chest pain or discomfort, cough, sweating and shortness of breath.

Clubbing of the fingernails may be present. There is a dull percussion note and reduced breath sounds on the affected side of the chest. Other diagnostic tools include chest x-ray, CT scan, and Ultrasonography.

Diagnosis

Diagnosis is confirmed by thoracentesis; frank pus may be aspirated from the pleural space. The pleural fluid typically has a low pH (<7.20), low glucose (<60 mg/dL), and contains infectious organisms.

CT chest showing large right sided hydropneumothorax from pleural empyema. Arrows A: air, B: fluid

Treatment

Definitive treatment for empyema entails drainage of the infected pleural fluid. A chest tube may be inserted, often using ultrasound guidance. Intravenous antibiotics are given. If this is insufficient, surgical debridement of the pleural space may be required.

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