What is Empyema?

Empyema is also called pyothorax or purulent pleurisy. It refers to a hunk of pus found in between the lungs and the chest cavity. Both the lungs and the chest cavity are covered in tissue called pleura. Normally, there is a fluid-filled space between them called the pleural cavity.

When a patient is sick with empyema, this space is filled with pus. The pus weighs down on the lungs and makes it hard to inhale. People of all ages can get empyema but people most at risk are smokers, drinkers, drug abusers, diabetics, suffer from acid reflux or have a compromised immune system.

The most common cause of empyema is pneumonia, but other respiratory ailments, a blood clot, a chest injury, chest surgery, complications from an endoscopy test or tuberculosis are also culprits.

What are the Symptoms of Empyema?

Patients may have all or just some symptoms when suffering from empyema.

Common symptoms include chest pain when breathing, difficulty breathing, fever, chills, unusual sweating like night sweats, sudden weight loss, constant fatigue, coughing which may be dry or may bring up pus mixed with the mucus a person normally coughs up.

These symptoms should never be ignored. Untreated empyema can permanently damage the lungs or develop into potentially deadly bacterial infection in the chest.

Empyema Causes

A viral, bacterial or fungal infection spreading to the lungs followed with a buildup of pus in the pleura space separating the lungs from the chest wall causes empyema. It’s normal to have a small amount of fluid in the pleura – it cushions your lungs to expand and contract when you breathe. Too much fluid, however, and breathing becomes difficult.

Autoimmune disorders, medications or cancer can cause empyema. Genetics pass on inherited genes of the sickle cell disease raising the risk of developing this condition. Injuries, surgeries and traumas to the chest can trigger the condition. When pressure is applied to the lungs, it irritates the pleura and induces inflammation followed by pain when you inhale or exhale.

In some cases, a needle inserted into the chest wall to draw out the pleural space fluid for medical diagnosis can trigger empyema. Medical instruments can transfer bacteria into the pleural space during surgery or treatments provoking condition. Two types of bacteria associated with pneumonia are streptococcus and staphylococcus; both cause infections in the pleura.

How is Empyema Treated?

The long-term prognosis for patients with empyema is good as long as treatment is begun as soon as possible. Diagnostic tests need to be done to help rule out other causes of the symptoms. Tests include blood tests, examining any pus coughed up (so save a sample if possible), chest X-ray, CT scan and a testing fluid in the pleural cavity with a needle.

Treatment includes

The usual treatment plan includes giving antibiotics intravenously and having a tube surgically placed in the chest to drain out the dangerous pus. Not all patients will need a chest drain tube. In some cases, antibiotics may be all that is needed.

Empyema Prevention

Preventing empyema starts with preventing illnesses like pneumonia and lifestyle habits like smoking; both are linked with respiratory disorders. If you have a low immune system, try to avoid individuals with colds or flu, since these germs spread quickly.

If you have a family history of the condition, talk with your doctor””antibiotic medications prevent infections related to empyema. Vaccinations for adults and children help to prevent illnesses leading to the condition.

See your doctor at once if you have trouble breathing to reduce the risk of developing a chronic pleural infection.

Practice good hygiene””wash your hands to prevent the spread of viruses and bacteria that cause infections. Be aware of your surroundings to prevent falling and injuring your chest.

Last Reviewed:
October 09, 2016
Last Updated:
December 19, 2017