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Empyema - Causes, Symptoms and Treatment

Empyema Definition

Empyema is the presence of pus in a body cavity, especially the pleural cavity. Empyema is the accumulation of pus and necrotic tissue in the pleural space. Normally, this space contains a small amount of extracellular fluid that lubricates the pleural surfaces. Accumulation of pus in the lung cavity, usually as a result of infection. Most commonly the pleural space surrounding the lungs.

Empyema results as a complication of bacterial infections such as pneumonia and lung abscess. Empyema in the pleural cavity is sometimes called empyema thoracis, or empyema of the chest.

Empyema Causes

Empyema may be caused by bacteria such as Streptococcus pneumonia, Staphylococcus aureus, or Haemophilus influenza type b. The infected fluid may be build up to a quantity of a pint or more, which puts pressure on the lungs, causing shortness of breath and pain. The infected fluid can build up to a quantity of a pint or more.

Empyema thoracis may be caused by a number of different organisms, fungi, and amebas, in connection with pneumonia, chest wounds, chest surgery, lung abscesses, or a ruptured esophagus. Pelvic empyema in women is most often caused by Bacteroides strains or Pseudomonas aeruginosa.

The formation of the empyema is conventionally divided into three phases:

  • exudative
  • fibrinopurulent
  • organizing

Empyema Symptoms

In case of empyema, Physical findings include tachypnea, and decreased breath sounds; percussion over the effused area, detects dullness, which doesn't change with breathing. The signs and symptoms of empyema vary somewhat according to the location of the infection and its severity. Ultrasound confirms the size and location of the pocket of pus and the presence of fibrin aggregates.

The symptoms of the empyema may be included:

  • fever
  • cough
  • coma
  • malaise
  • fatigue
  • sweating
  • weight loss
  • chest pain
  • general discomfort
  • shortness of breath

Empyema Treatments

The goal of treatment is to cure the infection and remove the collection of pus from the lung.

A chest tube is inserted to drain the pus from the pleural space.

Ultrasound has been used to evaluate empyema.

Some evidence suggests that intrapleural fibrinolytic drugs may be useful, especially in children.

Intravenous antibiotics may be given. If this is insufficient, surgical decortication of the pleura may be required.

 

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