Pleural empyema

Pleural empyema

A pleural empyema (also known as a pyothorax or purulent pleuritis) is an accumulation of pus in the pleural cavity. Most pleural empyemas arise from an infection within the lung (pneumonia), often associated with parapneumonic effusions. There are three stages: exudative, fibrinopurulent and organizing. In the exudative stage, the pus accumulates. This is followed by the fibrinopurulent stage in which there is loculation of the pleural fluid (the creation of grapelike pus pockets). In the final organizing stage, scarring of the pleural space may lead to lung entrapment.

ymptoms

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.

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.

External links

* [http://www.omdict.com/definition/empyema.php Empyema defined with causes, treatment, etc.]
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* [http://rad.usuhs.edu/medpix/medpix.html?mode=image_finder&action=search&srchstr=empyema&srch_type=all#top Images of Empyema] from MedPix


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  • empyema — [em΄pī ē′mə, em΄pē ē′mə] n. pl. empyemata [em΄pī ē′mə tə, em΄pē ē′mə tə] or empyemas [altered (infl. by Gr) < ME empima < ML empyema < Gr empyēma < empyein, to suppurate < en , in + pyon, PUS] the accumulation of pus in a body… …   English World dictionary

  • Pleural effusion — ICDO = OMIM = MedlinePlus = eMedicineSubj = eMedicineTopic = MeshID = D010996 Pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid filled space that surrounds the lungs. Excessive amounts of such fluid can impair… …   Wikipedia

  • empyema — Pus in a body cavity; when used without qualification, refers specifically to pyothorax. [G. e., suppuration, fr. en, in, + pyon, pus] e. benignum SYN: latent e.. e. of gallbladder severe acute cholecystitis with purulent inflammation of the …   Medical dictionary

  • empyema — empyemic, adj. /em pee ee meuh, puy /, n. Pathol. a collection of pus in a body cavity, esp. the pleural cavity. Also called pyothorax. [1605 15; < LL < Gk empýema abscess, equiv. to em EM 2 + pye (var. s. of pyeîn to suppurate, akin to pýon,… …   Universalium

  • Pleural effusion — Excess fluid between the two membranes that envelop the lungs. These membranes are called the visceral and parietal pleurae. The visceral pleura wraps around the lung while the parietal pleura lines the inner chest wall. There is normally a small …   Medical dictionary

  • empyema — pyothorax; n. pus in the pleural cavity, usually secondary to infection in the lung or in the space below the diaphragm. Empyema is a life threatening condition, which can be relieved by aspiration or drainage of the pus or by decapsulation (see… …   The new mediacal dictionary

  • empyema — em•py•e•ma [[t]ˌɛm piˈi mə, paɪ [/t]] n. pat a collection of pus in a body cavity, esp. the pleural cavity • Etymology: 1605–15; < LL < Gk empýēma, empyē , var. of empyeîn to suppurate em py•e′mic, adj …   From formal English to slang

  • empyema — [ˌɛmpʌɪ i:mə] noun Medicine the collection of pus in a body cavity, especially in the pleural cavity. Origin ME: via late L. from Gk empuēma, from empuein suppurate …   English new terms dictionary

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